CPG for Eating Disorders

9.7.2. Bulimia nervosa9.7.2.1. What is the efficacy of PDT in patients with BN?The answer to this question is based on the NICE CPG (2004) 30 , where it is described in terms ofseveral outcome variables. No evidence has been identified in later SRSE 31, 211 . The updatedsearch has not identified any new evidence on PDT in BN.Variables: reduction / remission of binge-eating andpurgingThere is insufficient evidence to determine that there are significant differencesbetween CBT and PDT in the frequency of binge-eating (1 RCT; N=46; Garner,1993 229 ; SMD: -0.19; 95% CI: -0.77 to 0.39) and purging (1 RCT; N=50; Garner,1993 229 ; SMD: -0.56; 95% CI: -1.13 to 0.01) by the end of treatment.RCT1++Variables: depression and/or interpersonal and psychosocial functioning and/orgeneral psychiatric symptomsThere is no evidence or insufficient evidence to determine that CBT-BN differs fromPDT in psychosocial and interpersonal functioning (1 RCT; N=41; Garner,1993 229 ;SMD: -0.39; 95% CI: -1.01 to 0.23) and in general psychiatric symptoms (1 RCT;N=48; Garner, 1993 229 ; SMD: -0.60; 95% CI: -1.18 to -0.02) by the end of treatment.RCT1++Summary of the Evidence(See also summary of the evidence for psychological treatment)CPG 30CBT does not offer any advantage over PDT.Recommendations(See recommendations 9.GP.12. to 9.GP.17.)9.7.2.2. What is the safety of PDT in patients with BN?The answer is based on the NICE CPG (2004) 30 , where different outcome variables aredescribed. No evidence has been identified in later SRSE 31, 211 . The updated search has notyielded any new evidence on PDT in BN.Scientific EvidenceThere is no significant evidence on the number of dropouts between CBT and PDT bythe end of treatment (1 RCT; N=50; Garner, 1993 229 ; RR: 1.00; 95% CI: 0.33 to 3.03).RCT1++129CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS