CPG for Eating Disorders

SRSE 2401++SRSE 2401++CBT treatment in patients with BN at 6 and 12 months follow-up produced a90% decrease in binge-eating and purging and, at one-year follow-up, 36% ofpatients remitted in terms of binge-eating and purging.Individual and group CBT treatment reduces the main symptoms of BN (bingeeatingand purging) and related short and long-term psychological effects.CPG 30CBT-GSH is superior to FT by reducing binge-eating more rapidly, being lessexpensive and more acceptable for adolescents with BN and/or EDNOS.Further research is necessary to determine if different groups of adolescentsrespond differently to FT and CBT-GSH and which different ways of involvingthe family in treatment can be more or less beneficial (Schmidt, 2007) 238 .RecommendationsA 9.3.2.1.1. CBT-BN is a specifically adapted form of CBT and it is recommended that16 to 20 sessions be performed over 4 or 5 months of treatment. (Adoptedfrom recommendation 7.2.7.3. of the NICE CPG). intervention can beincorporated. (Adopted from recommendation 7.2.7.4. of the NICE CPG).B 9.3.2.1.2.D 9.3.2.1.3.Patients with BN who do not respond to or refuse to receive CBTtreatment may be offered alternative psychological recommendation(Adopted from recommendation 7.2.7.5. of the NICE CPG).Adolescents with BN can be treated with CBT adapted to the their ageneeds, level of development, and, if appropriate, the family’s treatment.(Adopted from recommendation 7.2.7.4. of the NICE CPG).9.3.2.2. What is the safety of CBT in patients with BN?The answer is based on available evidence for CBT efficacy, where studies are briefly described(question 9.3.2.1.).Scientific EvidenceThere is evidence that indicates that CBT treatment dropout is not likely (9RCTs; N=384;Agras, 1989 222 ; Freeman, 1988 220 ; Griffits, 1994 217 ; Lee, 1986 218 ;Leitenberg, 1988 223 ; Wolf, 1992 221 ; Treasure, 1994 231 ; Mitchell, 1990 243 ; Sundgot-Borgen, 2002 212 ; RR: 1.14; 95% CI: 0.74 to 1.74).There is insufficient evidence that there are significant differences between CBT-BNand BT in the number of dropouts by the end of treatment (3 RCT; N=142; Fairburn,1991 224 ; Freeman, 1988 220 ; Wolf, 1992 221 ; RR: 1.20; 95% CI: 0.61 to 2.37).RCT1 ++RCT1 ++105CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS