CPG for Eating Disorders

Summary of the Evidence(See also the summary of the evidence for psychological treatment)SRSE 311++SRSE 311++SRSE 311++CPG 30There is little evidence to determine that CBT is more effective than NC in thenumber of patients with AN who recover and in weight gain.CBT did not prove to be more effective than BT or non-specific supportiveclinical management (NSCM) in AN patients’ weight restoration, generalbehaviour and attitudes regarding food. Based on the results, CBT does notexceed IPT.There is not enough evidence to determine that CBT is effective in the acutephase of AN.There is limited evidence to indicate that CBT is more acceptable than NC inAN inpatients after weight restoration (1 RCT; N=33; Pike, 2003) 210 .SRSE 311++CBT treatment can reduce recurrence risk in adults with AN after weightrestoration.Recommendations(See recommendations 9.GP.1. to 9.GP.11.)9.3.1.2. What is the safety of CBT in patients with AN?The answer is based on the evidence pertaining to the question on CBT efficacy (question9.3.1.1.): NICE’s CPG (2004) 30 and 2 high-quality SRSE (1++) (2006) 31 and (2007) 202 . Theupdated search did not yield any new evidence. Question 9.3.1.1. briefly describes the studies.Scientific EvidenceOne of the RCT (Channon, 1989) 215 reported that 13% of patients dropped out oftreatment. Dropouts per groups were: CBT: 0%, BT: 13%, control: 25%; and noadverse effects were reported in any group.In the second RCT (Pike, 2003) 210 , 9% dropped out of treatment (CBT 0%, NC 20%)and depression and suicidal ideations was reported in one case of the CBT group and 3of the NC group.The third RCT (McInstosh, 2005) 216 reported that 38% of studied patients dropped out oftreatment. Dropouts per groups were: CBT 37%, IPT 43%, non-specific supportiveclinical management (NSCM) 31%; however, no adverse effects were reported in anygroup.RCT1 +RCT1 +RCT1 +98CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS