title: Relapse predictors of patients with bulimia nervosa who achieved abstinence through cognitive behavioral therapy.
abstract: BACKGROUND
  Little information exists on relapse in patients with bulimia nervosa who responded with complete abstinence from binge eating and purging to cognitive behavioral therapy. Identification of relapse predictors may be useful to design effective early intervention strategies for relapse of susceptible patients with bulimia nervosa.
  
  
  METHODS
  This multisite study examined relapse in 48 patients with bulimia nervosa who had responded to cognitive behavioral therapy with complete abstinence from binge eating and purging. Structured interviews and questionnaires were used to assess patients before and after treatment and at 4 months after treatment.
  
  
  RESULTS
  Four months after treatment, 44% of the patients had relapsed. Those who relapsed had a higher level of preoccupation and ritualization of eating and less motivation for change, and had maintained abstinence for a shorter time during the treatment period.
  
  
  CONCLUSIONS
  The predictors of relapse found in this study can be readily determined by clinicians. The effectiveness of early additional treatment interventions needs to be determined with well-designed studies of large samples.
authors.affiliation: Department of Psychiatry, Weill Medical College of Cornell University, New York Presbyterian Hospital-Westchester Division, 21 Bloomingdale Rd, White Plains, NY 10605, USA. kah29@cornell.edu
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Halmi
authors.forename: W Stewart
authors.initials: WS
authors.lastname: Agras
authors.forename: James
authors.initials: J
authors.lastname: Mitchell
authors.forename: G Terence
authors.initials: GT
authors.lastname: Wilson
authors.forename: Scott
authors.initials: S
authors.lastname: Crow
authors.forename: Susan W
authors.initials: SW
authors.lastname: Bryson
authors.forename: Helena
authors.initials: H
authors.lastname: Kraemer
mesh_terms: D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors