CPG for Eating Disorders

Scientific EvidenceIn an RCT (Crisp, 1991; UK) 263 in adult women with AN the following treatments werecompared: G1) in inpatients: individual therapy-FT-group therapy-NC-occupationaltherapy (N=30); G2) in outpatients: individual psychological therapy-FT-NC (N=20);G3) in outpatients: group FT-NC (N=20); G4) control group (N=20). A two-yearfollow-up was conducted. Individual therapy and FT in outpatients is more effectivefor weight restoration at one or two years of follow-up. FT in adults with AN issuperior to standard treatments in increasing BMI, restoring menstruation and reducingbulimic symptoms.RCT1 +In an RCT (Dare, 2001; UK) 264 FT was compared to cognitive analytical therapy, focalsupportive psychotherapy (FSP) and standard treatments in adult patients with AN(98% women) under outpatient treatment. At one-year follow-up, FT and FSP wereassociated with increased weight gain and a greater proportion of patients who hadrecovered or showed significant improvement.RCT1 +In two RCTs (Russel, 1987; UK 265 ; Eisler, 1997 266 ) FT was compared to individualtherapy in 80 adolescent and adult females with AN under outpatient treatment. FTproved to be more effective in younger patients at earlier stages of the disease than inadults with chronic disease.RCT1 +In an RCT (Eisler, 2000; UK) 267 conjoint FT (family treated as a whole) was comparedto FT in separate sessions for the parents and patients in 40 adolescent outpatients (98%females) with AN. Conjoint FT was more effective at reducing depression andobsessive behaviours, but not in weight restoration. In families where the mother’scritical attitude was significant separate FT was more effective.In an RCT (Geist, 2000; Canada) 268 FT was compared to group family psychoeducationin 25 adolescent females inpatients with AN. There were no differences in both groupsat 16 weeks.RCT1 ++RCT1 +In an RCT (Robin, 1994 269 ; USA and 1995 270 ) behavioural SFT (parents have controlover the patient’s renutrition) was compared to ego-oriented individual therapy in 24adolescent female inpatients and outpatients with AN. Behavioural SFT was moreeffective at increasing BMI and restoring menstruation. There were no differencesbetween both therapies in terms of diet and the behaviour of patients.RCT1 +In an RCT (Lock, 2005; USA) 271 long-term FT (20 sessions over 12 months) wascompared to short-term FT (10 sessions in 6 months) in adolescents (90% females)outpatients with AN. Long-term therapy presents better overall results in patients withdestructured families and improves BMI in patients with severe diet-related obsessions.RCT1 ++123CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS