Effectiveness of intensive cognitive behavioral therapy in adolescents and adults with anorexia nervosa.

OBJECTIVE

This study aimed to compare the effectiveness of an intensive treatment based on enhanced cognitive behavioral therapy (CBT-E) in adolescent and adult patients with anorexia nervosa.

METHODS

A total of 150 consecutive patients (74 adolescents and 81 adults) were admitted to a 20-week intensive CBT-E program (13 weeks of inpatient followed by 7 weeks of day-hospital treatment). All patients had responded poorly to previous outpatient treatments and were assessed at admission, end of treatment (EOT), and 20- and 60-week follow-ups.

RESULTS

About 70% of eligible patients began the program, and more than 85% completed it. Body mass index (BMI) in adults and BMI-for-age percentile in adolescents improved significantly from baseline to EOT, remained stable until 20-week follow-up, and slightly decreased from 20-week follow-up to 60-week follow-up, while remaining in the lower normal range. Eating disorder psychopathology, general psychopathology, and clinical impairment scores decreased significantly at EOT and showed only a slight increase from EOT to follow-ups. No difference was found between adolescent and adult patients in treatment acceptance, dropout, or any outcome measure.

DISCUSSION: These findings indicate that intensive CBT-E seems to be an effective treatment for severely ill adolescent and adult patients with anorexia nervosa.