Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial - 18/04/17
Abstract |
Objective |
The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents.
Method |
In this randomized controlled trial, 81 female adolescents with BN or partial BN according to the DSM-IV received a mean of 36.6 sessions of manualized disorder−oriented PDT or CBT. Trained psychologists blinded to treatment condition administered the outcome measures at baseline, during treatment, at the end of treatment, and 12 months after treatment. The primary outcome was the rate of remission, defined as a lack of DSM-IV diagnosis for BN or partial BN at the end of therapy. Several secondary outcome measures were evaluated.
Results |
The remission rates for CBT and PDT were 33.3% and 31.0%, respectively, with no significant differences between them (odds ratio [OR] = 0.90, 95% CI = 0.35−2.28, p = .82). The within-group effect sizes were h = 1.22 for CBT and h = 1.18 for PDT. Significant improvements in all secondary outcome measures were found for both CBT (d = 0.51−0.82) and PDT (d = 0.24−1.10). The improvements remained stable at the 12-month follow-up in both groups. There were small between-group effect sizes for binge eating (d = 0.23) and purging (d = 0.26) in favor of CBT and for eating concern (d = −0.35) in favor of PDT.
Conclusion |
CBT and PDT were effective in promoting recovery from BN in female adolescents. The rates of remission for both therapies were similar to those in other studies evaluating CBT. This trial identified differences with small effects in binge eating, purging, and eating concern.
Clinical trial registration information—Treating Bulimia Nervosa in Female Adolescents With Either Cognitive-Behavioral Therapy (CBT) or Psychodynamic Therapy (PDT). isrctn.com/; ISRCTN14806095.
Le texte complet de cet article est disponible en PDF.Key words : bulimia nervosa, female adolescents, cognitive-behavioral therapy, psychodynamic therapy
Plan
The study was funded by the Vereinigung Analytischer Kinder- und Jugendlichen-Psychotherapeuten in Deutschland e.V. (VAKJP/Association of psychoanalytic child- and adolescent-psychotherapists in Germany) and Lou Andreas-Salomè-Institut für Psychoanalyse und Psychotherapie, Goettingen. |
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Drs. Stefini and Salzer contributed equally and share first authorship. |
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The authors thank all the young women and therapists for their participation in the study. |
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Disclosure: Drs. Stefini, Salzer, Reich, Winkelmann, Bents, Ruhl, Kronmüller and Mss. Horn, Rutz, Frost, v. Boetticher, Specht report no biomedical financial interests or potential conflicts of interest. |
Vol 56 - N° 4
P. 329-335 - avril 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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