Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa.
OBJECTIVE
This study provides what the authors believe is the first empirical evaluation of cognitive behavior therapy as a posthospitalization treatment for anorexia nervosa in adults.


METHODS
After hospitalization, 33 patients with DSM-IV anorexia nervosa were randomly assigned to 1 year of outpatient cognitive behavior therapy or nutritional counseling.


RESULTS
The group receiving nutritional counseling relapsed significantly earlier and at a higher rate than the group receiving cognitive behavior therapy (53% versus 22%). The overall treatment failure rate (relapse and dropping out combined) was significantly lower for cognitive behavior therapy (22%) than for nutritional counseling (73%). The criteria for "good outcome" were met by significantly more of the patients receiving cognitive behavior therapy (44%) than nutritional counseling (7%).


CONCLUSIONS
Cognitive behavior therapy was significantly more effective than nutritional counseling in improving outcome and preventing relapse. To the authors' knowledge, these data provide the first empirical documentation of the efficacy of any psychotherapy, and cognitive behavior therapy in particular, in posthospitalization care and relapse prevention of adult anorexia nervosa.
Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA. kmp2@columbia.edu
Kathleen M
KM
Pike
B Timothy
BT
Walsh
Kelly
K
Vitousek
G Terence
GT
Wilson
Joy
J
Bauer
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods*; D000553:Ambulatory Care / Q000379:methods*; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003376:Counseling / Q000379:methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010352:Patient Dropouts; D055502:Secondary Prevention; D016896:Treatment Outcome