title: Intensive inpatient treatment for bulimia nervosa: Statistical and clinical significance of symptom changes.
abstract: This study examines the statistical and clinical significance of symptom changes during an intensive inpatient treatment program with a strong psychotherapeutic focus for individuals with severe bulimia nervosa.
  
  
  
  295 consecutively admitted bulimic patients were administered the Structured Interview for Anorexic and Bulimic Syndromes-Self-Rating (SIAB-S), the Eating Disorder Inventory-2 (EDI-2), the Brief Symptom Inventory (BSI), and the Beck Depression Inventory-II (BDI-II) at treatment intake and discharge.
  
  
  
  Results indicated statistically significant symptom reductions with large effect sizes regarding severity of binge eating and compensatory behavior (SIAB-S), overall eating disorder symptom severity (EDI-2), overall psychopathology (BSI), and depressive symptom severity (BDI-II) even when controlling for antidepressant medication. The majority of patients showed either reliable (EDI-2: 33.7%, BSI: 34.8%, BDI-II: 18.1%) or even clinically significant symptom changes (EDI-2: 43.2%, BSI: 33.9%, BDI-II: 56.9%). Patients with clinically significant improvement were less distressed at intake and less likely to suffer from a comorbid borderline personality disorder when compared with those who did not improve to a clinically significant extent.
  
  
  
  Findings indicate that intensive psychotherapeutic inpatient treatment may be effective in about 75% of severely affected bulimic patients. For the remaining non-responding patients, inpatient treatment might be improved through an even stronger focus on the reduction of comorbid borderline personality traits.
authors.affiliation: a Department of Psychiatry and Psychotherapy , University of Munich (LMU) , Munich , Germany.
authors.forename: Alice
authors.initials: A
authors.lastname: Diedrich
authors.affiliation: a Department of Psychiatry and Psychotherapy , University of Munich (LMU) , Munich , Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Schlegl
authors.affiliation: b Schön Clinic Roseneck , Prien am Chiemsee , Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Greetfeld
authors.affiliation: b Schön Clinic Roseneck , Prien am Chiemsee , Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Fumi
authors.affiliation: b Schön Clinic Roseneck , Prien am Chiemsee , Germany.|c Department of Psychiatry and Psychotherapy , University of Freiburg , Freiburg , Germany.
authors.forename: Ulrich
authors.identifier: 0000-0003-0261-3145
authors.initials: U
authors.lastname: Voderholzer
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007297:Inpatients; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012720:Severity of Illness Index; D055815:Young Adult
keywords: borderline personality disorder; bulimia nervosa; cognitive-behavioral therapy; intensive inpatient treatment; statistical and clinical significance; symptom severity