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Both focused and enhanced cognitive behavioural therapy improve eating disorder symptom severity

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Question

Question:

Is a complex cognitive behavioural therapy (CBT) package addressing mood intolerance, clinical perfectionism, low self-esteem and interpersonal difficulties more effective than CBT focused on eating disorder symptoms alone?

Patients:

154 adults attending eating disorder clinics (95.5% female; mean age 26.1 years; 38.3% had bulimia nervosa). Participants had to have a body mass index >17.5 and those who had received similar previous CBT or with a psychiatric disorder were excluded. Clinically warranted antidepressants were allowed during the trial.

Setting:

Two eating disorder clinics in the UK (Oxfordshire and Leicester), recruitment was March 2002–July 2005.

Intervention:

Enhanced CBT, focused CBT or waiting list control. Enhanced CBT covered mood intolerance, clinical perfectionism, low self-esteem, interpersonal difficulties as well as aspects of eating disorders, while focused CBT covered only specific eating disorder features such as shape and weight, binging and purging. Both CBT groups received a 90 min initial session, then 20 sessions of 50 min duration and a review session 20 weeks after treatment. The waiting list control group were assessed after 8 weeks and then received one of the two CBT treatments.

Outcomes:

Two primary outcomes, both measured using the …

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