Treatment of eating disorders - Review of findings from controlled psychotherapy and pharmacotherapy studies

Author(s): Karwautz, A., Strnad, A.

Journal/Book: Psychotherapeut. 1996; 41: 175 Fifth Ave, New York, NY 10010. Springer Verlag. 275-287.

Abstract: The following review will examine the outcome of psychotherapy and pharmacotherapy treatment studies of anorexia and bulimia nervosa. For both eating disorders, psychotherapy is the treatment of choice. In clinical practice ''treatment packages'' are offered to account for the complexity of the disorders. In bulimia nervosa, cognitive-behavioral therapy techniques have dominated the literature and appear to be successful. Newer studies reporting on the use of interpersonal therapy also find considerable improvement of symptoms. Antidepressive medication can be useful in the treatment of bulimia nervosa. Recently, a stepped care approach to treatment has been recommended, with self-care manuals as the first step. In anorexia nervosa there is a paucity of controlled clinical trials. Contingency management for weight restoration can be viewed as a necessary element in all in- and outpatient treatments. Family therapy, cognitive-behavioral therapy, and psychodynamic approaches have proven useful in clinical practice, however, only a limited data base exists regarding the efficacy of these therapies. Medication should not be used routinely in the treatment of anorexia nervosa.

Note: Review M Dezwaan, Univ Vienna, Psychiat Klin, ABT Allgemeine Psychiat, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

Keyword(s): psychotherapy; pharmacotherapy; anorexia nervosa; bulimia nervosa; controlled trials; COGNITIVE-BEHAVIORAL TREATMENT; 2 PSYCHOLOGICAL TREATMENTS; PLUS RESPONSE-PREVENTION; SHORT-TERM TREATMENT; BULIMIA-NERVOSA; ANOREXIA-NERVOSA; CONTROLLED TRIAL; DOUBLE-BLIND; FOLLOW-UP; ANTIDEPRESSANT TREATMENT

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