title: An evaluation of the efficacy of supervised cognitive behavioral self-help bulimia nervosa.
abstract: Eighty two patients with bulimia nervosa were managed by providing them with supervision in the use of a highly structured cognitive behavioral self-help manual. Their progress was assessed in an open clinical trial. The 67 patients who completed the course of self-help experienced considerable benefit; the frequency of bulimic episodes and self-induced vomiting decreasing by 80% and 79%, respectively. Compared to those who benefited, those who had a poor outcome or dropped out of treatment were more than twice as likely to have had anorexia nervosa in the past and were somewhat more likely to have a personality disorder. Three-quarters of those who persisted with the programme of supervised self-help were followed up a year after commencing treatment. Clinical gains were well maintained: almost two thirds were abstinent with respect to both bulimic episodes and self-induced vomiting. It would seem appropriate that, as part of a stepped care approach to the management of bulimia nervosa, supervised cognitive behavioral self-help should routinely be the first line treatment.
authors.affiliation: Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, U.K.
authors.forename: P J
authors.initials: PJ
authors.lastname: Cooper
authors.forename: S
authors.initials: S
authors.lastname: Coker
authors.forename: C
authors.initials: C
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D008370:Manuals as Topic; D010555:Personality Inventory; D011369:Professional-Patient Relations; D012648:Self Care / Q000523:psychology*; D016896:Treatment Outcome