A randomized controlled comparison of family-based treatment and supportive psychotherapy for adolescent bulimia nervosa.
BACKGROUND
Evidenced-based treatment trials for adolescents with bulimia nervosa are largely absent.


OBJECTIVE
To evaluate the relative efficacy of family-based treatment (FBT) and supportive psychotherapy (SPT) for adolescents with bulimia nervosa.


METHODS
Randomized controlled trial.


METHODS
The University of Chicago from April 1, 2001, through June 30, 2006.


METHODS
Eighty patients, aged 12 to 19 years, with a DSM-IV diagnosis of bulimia nervosa or a strict definition of partial bulimia nervosa.


METHODS
Twenty outpatient visits over 6 months of FBT or SPT. Participants were followed up at 6 months posttreatment.


METHODS
Abstinence from binge-and-purge episodes as measured by the Eating Disorder Examination. Secondary outcome measures were Eating Disorder Examination binge-and-purge frequency and Eating Disorder Examination subscale scores.


RESULTS
Forty-one patients were assigned to FBT and 39 to SPT. Categorical outcomes at posttreatment demonstrated that significantly more patients receiving FBT (16 [39%]) were binge-and-purge abstinent compared with those receiving SPT (7 [18%]) (P = .049). Somewhat fewer patients were abstinent at the 6-month follow-up; however, the difference was statistically in favor of FBT vs SPT (12 patients [29%] vs 4 patients [10%]; P = .05). Secondary outcome assessment, based on random regression analysis, revealed main effects in favor of FBT on all measures of eating pathological features (P = .003 to P = .03 for all).


CONCLUSIONS
Family-based treatment showed a clinical and statistical advantage over SPT at posttreatment and at 6-month follow-up. Reduction in core bulimic symptoms was also more immediate for patients receiving FBT vs SPT.
le Grange
Daniel
D
Department of Psychiatry, The University of Chicago, Chicago, IL 60637, USA. legrange@uchicago.edu
Crosby
Ross D
RD
Rathouz
Paul J
PJ
Leventhal
Bennett L
BL
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D001294:Attitude to Health; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D000297:Psychology, Adolescent; D011613:Psychotherapy / Q000379:methods*; D012044:Regression Analysis; D016896:Treatment Outcome