Cognitive Behavior Therapy in the Posthospitalization Treatment of Anorexia Nervosa

TLDR

The study aims to empirically evaluate cognitive behavior therapy as a posthospitalization treatment for adult anorexia nervosa. Thirty‑three adults with anorexia nervosa were randomized after hospitalization to one year of outpatient CBT or nutritional counseling. CBT resulted in significantly lower relapse (22% vs 53%) and overall failure (22% vs 73%) rates, higher good outcome rates (44% vs 7%), and proved more effective than nutritional counseling in preventing relapse.

Abstract

OBJECTIVE: This study provides what the authors believe is the first empirical evaluation of cognitive behavior therapy as a posthospitalization treatment for anorexia nervosa in adults. METHOD: After hospitalization, 33 patients with DSM-IV anorexia nervosa were randomly assigned to 1 year of outpatient cognitive behavior therapy or nutritional counseling. RESULTS: The group receiving nutritional counseling relapsed significantly earlier and at a higher rate than the group receiving cognitive behavior therapy (53% versus 22%). The overall treatment failure rate (relapse and dropping out combined) was significantly lower for cognitive behavior therapy (22%) than for nutritional counseling (73%). The criteria for “good outcome” were met by significantly more of the patients receiving cognitive behavior therapy (44%) than nutritional counseling (7%). CONCLUSIONS: Cognitive behavior therapy was significantly more effective than nutritional counseling in improving outcome and preventing relapse. To the authors’ knowledge, these data provide the first empirical documentation of the efficacy of any psychotherapy, and cognitive behavior therapy in particular, in posthospitalization care and relapse prevention of adult anorexia nervosa.