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Cited by 291Eating Disorders and BehaviorsNutrition, Health and Food BehaviorAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Treating severe and enduring anorexia nervosa: a randomized controlled trial

Touyz, S., Le Grange, D., Lacey, H., Hay, P., Smith, R., Maguire, S., Bamford, B., Pike, K. M. +1 more·2013·Psychological Medicine
DOI 10.1017/s0033291713000949
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Abstract

Background: There are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive clinical management (SSCM) for adults with SE-AN. Method: Sixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes. Results: Thirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores ( p = 0.004) and higher readiness for recovery ( p = 0.013) compared to SSCM. Conclusions: Patients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.

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Authors
Touyz, S., Le Grange, D., Lacey, H., Hay, P., Smith, R., Maguire, S., Bamford, B., Pike, K. M., & Crosby, R. D.
Affiliations
  • The University of Sydney (AU)
  • St George's, University of London (GB)
  • Western Sydney University (AU)
  • Columbia University (US)
  • University of North Dakota (US)
Corresponding author
Touyz, S.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2013-05-03
Volume
43
Issue
12
Pages
2501-2511
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291713000949
OpenAlex
W2133783100
Cited by
291
References
44
Citations by year
2026: 10 · 2025: 11 · 2024: 31 · 2023: 21 · 2022: 21 · 2021: 21 · 2020: 24 · 2019: 19 · 2018: 21 · 2017: 29 · 2016: 26 · 2015: 24 · 2014: 24 · 2013: 8
FWCI
30.34
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchOnline - JCU (James Cook University) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
severe and enduring anorexia nervosa, treatment efficacy, social adaptation, eating disorder psychopathology, quality of life, treatment retention, chronic disease
MeSH terms
Adult, Anorexia Nervosa, Depression, Female, Follow-Up Studies, Humans, Middle Aged, Motivation, Quality of Life, Severity of Illness Index, Social Adjustment, Social Support, Cognitive Behavioral Therapy, Treatment Outcome, Cost of Illness, Disease Management, Young Adult

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