A comparison of short- and long-term family therapy for adolescent anorexia nervosa.
OBJECTIVE
Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy.


METHODS
Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months) and evaluated at the end of 1 year using the Eating Disorder Examination (EDE) between 1999 and 2002.


RESULTS
Although adequately powered to detect differences between treatment groups, an intent-to-treat analysis found no significant differences between the short-term and long-term treatment groups. Although a nonsignificant finding does not prove the null hypothesis, in no instance does the confidence interval on the effect size on the difference between the groups approach a moderate .5 level. However, post hoc analyses suggest that subjects with severe eating-related obsessive-compulsive features or who come from nonintact families respond better to long-term treatment.


CONCLUSIONS
A short-term course of family therapy appears to be as effective as a long-term course for adolescents with short-duration anorexia nervosa. However, there is a suggestion that those with more severe eating-related obsessive-compulsive thinking and nonintact families benefit from longer treatment.
Lock
James
J
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA. jimlock@stanford.edu
Agras
W Stewart
WS
Bryson
Susan
S
Kraemer
Helena C
HC
D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief; D012720:Severity of Illness Index; D020954:Single-Parent Family; D013997:Time Factors