An evaluation of family therapy in anorexia nervosa and bulimia nervosa.

A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken. Eighty patients (57 with anorexia nervosa; 23 with bulimia nervosa) were first admitted to a specialized unit to restore their weight to normal. Before discharge, they were randomly allocated to family therapy or the control treatment (individual supportive therapy). After one year of psychological treatment, they were reassessed, using body weight, menstrual function, and ratings on the Morgan and Russell scales. Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years. A more tentative finding was the greater value of individual supportive therapy in older patients. To our knowledge, this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment.

[1]  H. Babigian,et al.  Epidemiology of Anorexia Nervosa in Monroe County, New York: 1960‐1976 , 1980, Psychosomatic medicine.

[2]  J. Mitchell,et al.  A Placebo‐Controlled, Double‐Blind Trial of Amitriptyline in Bulimia , 1984, Journal of clinical psychopharmacology.

[3]  I. Eisler,et al.  Anorexia Nervosa, Parental ‘Expressed Emotion’ and Dropping Out of Treatment , 1985, British Journal of Psychiatry.

[4]  G. Szmukler,et al.  Anorexia nervosa: a psychiatric case register study from Aberdeen , 1986, Psychological Medicine.

[5]  M. Palazzoli Self-starvation: From individual to family therapy in the treatment of anorexia nervosa , 1978 .

[6]  J. Lacey Bulimia nervosa, binge eating, and psychogenic vomiting: a controlled treatment study and long term outcome. , 1983, British medical journal.

[7]  K. H. Barratt,et al.  Bulimia nervosa: a placebo controlled double-blind therapeutic trial of mianserin. , 1983, British journal of clinical pharmacology.

[8]  R E Kendell,et al.  The epidemiology of anorexia nervosa , 1973, Psychological Medicine.

[9]  I. Marks,et al.  A feasibility study for a controlled trial of formal psychotherapy , 1972, Psychological Medicine.

[10]  Salvador Minuchin,et al.  Psychosomatic families : anorexia nervosa in context , 1978 .

[11]  T. Burns,et al.  Outcome of Anorexia Nervosa in Males , 1984, British Journal of Psychiatry.

[12]  D. Garner,et al.  The Eating Attitudes Test: an index of the symptoms of anorexia nervosa , 1979, Psychological Medicine.

[13]  G. Russell,et al.  Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients , 1975, Psychological Medicine.

[14]  S. Theander,et al.  Outcome and prognosis in anorexia nervosa and bulimia: some results of previous investigations, compared with those of a Swedish long-term study. , 1985, Journal of psychiatric research.

[15]  G Russell,et al.  Bulimia nervosa: an ominous variant of anorexia nervosa , 1979, Psychological Medicine.

[16]  C. Fairburn,et al.  A cognitive behavioural approach to the treatment of bulimia , 1981, Psychological Medicine.

[17]  H G Pope,et al.  Bulimia treated with imipramine: a placebo-controlled, double-blind study. , 1983, The American journal of psychiatry.

[18]  M. Hamilton,et al.  Assessment of the severity of primary depressive illness: Wakefield self-assessment depression inventory , 1971, Psychological Medicine.

[19]  C. Fairburn The management of bulimia nervosa. , 1985, Journal of psychiatric research.

[20]  L. K. G Hsu,et al.  OUTCOME OF ANOREXIA NERVOSA , 1979, The Lancet.

[21]  T. Todd,et al.  A conceptual model of psychosomatic illness in children. Family organization and family therapy. , 1975, Archives of general psychiatry.

[22]  S. Theander Anorexia nervosa. A psychiatric investigation of 94 female patients. , 1970, Acta psychiatrica Scandinavica. Supplementum.