A randomized controlled two-stage trial in the treatment of bulimia nervosa, comparing CBT versus motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2.
OBJECTIVE
To conduct a randomized, controlled, two-stage trial in the treatment of bulimia nervosa, comparing cognitive-behavioral therapy (CBT) versus motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2.


METHODS
A total of 225 patients with bulimia nervosa or eating disorder not otherwise specified (EDNOS) were recruited into a randomized controlled trial lasting 12 weeks with follow-ups at 1 year and 2.5 years.


RESULTS
Patients improved significantly across all of the interventions with no differences in outcome or treatment adherence. Including motivational enhancement therapy rather than a CBT first phase of treatment did not affect outcome.


CONCLUSIONS
Outcome differences between individual and group CBT were minor, suggesting that group treatment prefaced by a short individual intervention may be a cost-effective alternative to purely individual treatment.
Katzman
Melanie A
MA
Department of Psychiatry, Weill Cornell Medical Center, New York, NY 10075, USA. mkatzman@katzmanconsulting.com
Bara-Carril
Nuria
N
Rabe-Hesketh
Sophia
S
Schmidt
Ulrike
U
Troop
Nicholas
N
Treasure
Janet
J
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D001068:Feeding and Eating Disorders / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009042:Motivation; D010349:Patient Compliance; D010352:Patient Dropouts; D011615:Psychotherapy, Group / Q000379:methods; D012107:Research Design; D016896:Treatment Outcome