Bulimia Nervosa Clinical Trial
Official title:
Family Therapy for Adolescent Bulimia Nervosa: A Controlled Comparison
The primary hypotheses are:
- A procedurally distinct family therapy is an effective and essential way to reduce
bingeing and purging in adolescents with BN, and leads to the long-term amelioration of
bulimic symptoms.
- Family therapy is an effective way to bring about meaningful improvements in family
interaction.
- Family therapy will produce significantly larger reductions in bulimic symptoms and
improved family interaction in adolescents with BN compared to a control supportive
psychotherapy.
Bulimia nervosa (BN) is a disabling eating disorder and affects as many as 2% of young
women. It is a major source of psychiatric and medical morbidity that often impairs several
areas of functioning. Even more alarming is the fact that BN is occurring with increasing
frequency among adolescents and preadolescents. Applying stringent diagnostic criteria for
BN, studies have found 2-5% of adolescent girls surveyed qualify for diagnosis of BN.
Research specific to treatment of child and adolescent eating disorders remains limited. No
psychological treatment has been systematically evaluated in the treatment of adolescents
with BN. However, a series of studies from the Maudsley Hospital in London have shown that
family therapy (the 'Maudsley Approach') is effective in the treatment of adolescents with
anorexia nervosa (AN). These studies have shown that involving the parents and siblings in
treatment has beneficial effects on reversing the course of the eating disorder as well as
improving family interaction. A preliminary report from the Maudsley group has also shown
that the 'Maudsley Approach' may be helpful in the treatment of adolescents with BN. Because
most young adolescents still live with their families of origin, this raises the interesting
clinical question that adolescent BN patients can also be successfully treated with family
therapy.
The proposed study has two specific aims:
1. To adapt and pilot a recently developed family therapy manual for adolescent AN for use
in the treatment of adolescent BN patients.
2. To compare the efficacy of this conceptually and procedurally distinct family therapy
treatment with individual control psychotherapy.
To achieve these aims, we propose a five-year controlled treatment study to be carried out
at The University of Chicago. Eighty newly referred adolescent patients meeting DSM-IV
diagnostic criteria for BN will be randomly allocated to one of two groups: 1) family
therapy or 2) the individual supportive control treatment. All patients will receive the
same medical evaluation and monitoring throughout the study period. Assessment of
psychiatric and medical outcome measures will be carried out at the onset of treatment,
during treatment, at the end of treatment, and again at one-year follow-up. The clinical
outcome variables assessed will include the EDE, KSADS, RSE, and EE.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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