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Psychological therapies in anorexia nervosa

The Cullen Centre, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF, UK

EDITED BY MATTHEW HOTOPF

It is heartening to see trials of therapy for anorexia nervosa, the most lethal of psychiatric illnesses and the cinderella of research. Dare et al (2001) have shown that over a year it is possible to effectively treat a severely ill group of young adults with poor prognostic features, and to do so on an out-patient basis.

I am surprised, though, that they feel able to conclude that "specialised psychotherapies are more effective than routine treatment". The two therapies which came out ‘top’ (family therapy and focal psychoanalytic psychotherapy) were given by the same three highly experienced therapists, and the next best therapy (cognitive—analytic therapy) was given by trained specialists in eating disorders, whereas ‘routine treatment’ was provided by junior psychiatrists on 6-month rotations who had to hand over to colleagues during the year of patient contract.

Certainly, confidence in at least one model of therapy is an important component of an experienced therapist's effectiveness, but for me the clearest implication of the study is that patients who suffer from this chronic condition do best with continuity of care from the most experienced therapists. I am not sure we can say anything at all yet about choice of specific therapy.

REFERENCES

Dare, C., Eisler, I., Russell, G., et al (2001) Psychological therapies for adults with anorexia nervosa. Randomised controlled trial of out-patient treatments. British Journal of Psychiatry, 178, 216-221.[Abstract/Free Full Text]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Morris, J. Search for Related Content PubMed PubMed Citation Articles by Morris, J.