A randomised controlled trial of three psychological treatments for anorexia nervosa
Open accessAbstract
BACKGROUND: There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy. METHOD: A multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25-40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment. RESULTS: Treatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up. CONCLUSION: The findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/.
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No specific therapeutic approach has been found to be the most effective in adults with anorexia nervosa.
“Although no specific therapeutic approach has been found to be the most effective in adults with AN (Byrne et al., 2017; Watson and Bulik, 2013)”
From Feasibility of guided internet-based cognitive behavioral therapy for patients with anorexia nervosa (2022) · cites this paper as Byrne et al., 2017
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“…therapy (CBT-E; Fairburn, 2008) for adult EDs, the remission rates range from 21.8& to 55% during post-treatment follow-ups (Allen et al., 2011; Byrne et al., 2017; Frostad et al., 2018; Frostad & Bentz, 2022; Le Grange et al., 2020; Poulsen et al., 2014; Wade et al., 2017; Wonderlich et al.,…”
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- Authors
- Byrne, S., Wade, T., Hay, P., Touyz, S., Fairburn, C. G., Treasure, J., Schmidt, U., McIntosh, V., Allen, K., Fursland, A., & Crosby, R. D.
- Affiliations
- The University of Western Australia (AU)
- Flinders University (AU)
- Western Sydney University (AU)
- The University of Sydney (AU)
- University of Oxford (GB)
- King's College London (GB)
- University of Otago (NZ)
- Curtin University (AU)
- University of North Dakota (US)
- Corresponding author
- Byrne, S.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-05-29
- Volume
- 47
- Issue
- 16
- Pages
- 2823-2833
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2619816586
- Cited by
- 203
- References
- 49
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 27 · 2023: 31 · 2022: 27 · 2021: 27 · 2020: 18 · 2019: 22 · 2018: 15 · 2017: 7 · 2016: 1
- FWCI
- 20.98
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- 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
- anorexia nervosa, psychotherapy, treatment comparison, body mass index, eating disorder psychopathology, depression, anxiety, psychosocial impairment, remission, outpatient care
- MeSH terms
- Adolescent, Adult, Ambulatory Care, Anorexia Nervosa, Australia, Body Weight, Female, Humans, Male, Psychotherapy, Body Mass Index, Treatment Outcome, Young Adult
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