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What is already known on this topic?
Bulimia nervosa is characterised by binge eating and inappropriate compensatory behaviours in the context of severe weight and/or shape concern. Despite empirical evidence supporting the efficacy of several psychological treatments for bulimia nervosa (eg, cognitive behaviour therapy and interpersonal psychotherapy), these treatments are characterised by variable remission rates, high drop-out rates, high relapse rates and variable levels of acceptability and implementation by clinicians.1–3 Thus, additional treatments for bulimia nervosa are needed. It has been hypothesised that long-term psychoanalytic psychotherapy may be one promising approach to treating this disorder given its emphasis on increasing distress tolerance and insight into the functionality of symptoms. However, long-term psychoanalytic psychotherapy has not previously been studied for the treatment of bulimia nervosa.
What does this paper add?
This study represents the first randomised controlled trial of long-term psychoanalytic psychotherapy (24 months of treatment) for bulimia nervosa and the first randomised controlled trial comparing enhanced cognitive behavioural therapy (CBT-E; 5 months of treatment) to another active treatment for bulimia nervosa.
CBT-E was superior to long-term psychoanalytic psychotherapy with regard to abstinence from binge eating and purging at 5 months (ie, at the conclusion of CBTE-E and 5 months into long-term psychoanalytic psychotherapy) and 24 months (ie, at the conclusion of long-term psychoanalytic psychotherapy and 19 months after the conclusion of CBT-E) after the onset of treatment.
Twenty-four months after the start of treatment, there were no significant differences between the two treatment …
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