A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa.
BACKGROUND
Research suggests that cognitive-behavioral therapy (CBT) is the most effective psychotherapeutic treatment for bulimia nervosa. One exception was a study that suggested that interpersonal psychotherapy (IPT) might be as effective as CBT, although slower to achieve its effects. The present study is designed to repeat this important comparison.


METHODS
Two hundred twenty patients meeting DSM-III-R criteria for bulimia nervosa were allocated at random to 19 sessions of either CBT or IPT conducted over a 20-week period and evaluated for 1 year after treatment in a multisite study.


RESULTS
Cognitive-behavioral therapy was significantly superior to IPT at the end of treatment in the percentage of participants recovered (29% [n=32] vs 6% [n=71), the percentage remitted (48% [n=53] vs 28% [n = 31]), and the percentage meeting community norms for eating attitudes and behaviors (41% [n=45] vs 27% [n=30]). For treatment completers, the percentage recovered was 45% (n= 29) for CBT and 8% (n= 5) for IPT. However, at follow-up, there were no significant differences between the 2 treatments: 26 (40%) CBT completers had recovered at follow-up compared with 17 (27%) IPT completers.


CONCLUSIONS
Cognitive-behavioral therapy was significantly more rapid in engendering improvement in patients with bulimia nervosa than IPT. This suggests that CBT should be considered the preferred psychotherapeutic treatment for bulimia nervosa.
Agras
W S
WS
Department of Psychiatry and Behavioral Sciences, Stanford University, Calif 94305, USA. sagras@leland.stanford.edu
Walsh
T
T
Fairburn
C G
CG
Wilson
G T
GT
Kraemer
H C
HC
D000328:Adult; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005500:Follow-Up Studies; D006801:Humans; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011613:Psychotherapy; D015203:Reproducibility of Results; D016896:Treatment Outcome