A brief form of interpersonal psychotherapy for adult patients with bulimic disorders: a pilot study.

OBJECTIVE: The aim of the study was to pilot a brief form of interpersonal psychotherapy (IPT) for the treatment of patients with bulimic disorders. METHOD: Ten patients with bulimic disorder treated with a new brief version of IPT (IPT-BN10) completed measurements of eating disorders psychopathology (Eating Disorders Examination Questionnaire, Bulimic Investigatory Test Edinburgh) and depression (Beck Depression Inventory). The results were matched with a group of patients treated with conventional IPT and with waiting list control. RESULTS: Statistical differences were found between starting and ending of therapy for those patients treated with IPT-BN10. Statistical difference was also found when comparing with waiting list control. DISCUSSION: The pilot study suggests that IPT-BN10 may be an effective treatment for patients having bulimic disorders; however, this hypothesis needs to be tested in an experimental way.

Factores predictores del tratamiento de la bulimia nerviosa con Terapia Interpersonal / Predictors of Interpersonal Psychotherapy in patients with bulimic eating disorders

Objetivo: Determinar los factores de pronóstico del tratamiento de la bulimia nerviosa con terapia interpersonal. Diseño: 80 pacientes con el diagnostico de Bulimia Nerviosa (BN) o trastornos del comportamiento alimentario no especificados con características de BN (TCANE) fueron tratados con 16 sesiones de terapia interpersonal. Los pacientes fueron evaluados utilizando una entrevista semi-estructural (Clinical Eating Disorders Rating Instrument-CEDRIC). También completaron una batería de cuestionarios para evaluar los niveles de estima personal (Rosenberg Self-esteem Scale -RSE), la psicopatología de los trastornos de la alimentación (Eating Disorders Examination Questionnaire-EDE-Q), la función interpersonal (Inventory of Interpersonal Functioning-IIP-32) y los niveles de depresión (Beck Depression Inventory-BDI). Método: El pronóstico de interés fue definido por la variable de remisión y recuperación. Para el análisis del estudio se realizaron una serie de regresiones logísticas. Resultado: Baja estima personal, y una menor patología en la función interpersonal fueron los factores de peor pronóstico. Conclusión: Aunque la terapia interpersonal es un tratamiento efectivo para las personas que sufren de bulimia nerviosa, los pacientes con estas patologías con baja estima personal y menos problemas interpersonales deberían de ser tratados con otro tipo de terapia.

Objective: To determine predictors of treatment outcomes in patients with Bulimic Eating Disorders treated with Interpersonal Psychotherapy (IPT). Design: Following initial assessment, 80 patients with diagnoses of Bulimia Nervosa or Eating Disorders Not Otherwise Specified (EDNOS), entered treatment in the form of 16 sessions of IPT. Patients were assessed using a validated semi-structure interview (Clinical Eating Disorders Rating Instrument-CEDRIC) and completed measures of self-esteem (Rosenberg Self-esteem Scale-RSE), eating psychopathology (Eating Disorders Examination Questionnaire-EDE-Q), interpersonal functioning (Inventory of Interpersonal Functioning- IIP-32), and depression (Beck Depression Inventory-BDI). Method: Remission and recovery after 16 sessions of IPT were the two outcomes of interest. Univariate analysis and a series of backwards stepping logistic regressions were performed to determine the variables associated with remission and recovery. Result: Low self-esteem and less interpersonal problems were the main predictors of poor outcome. Conclusion: As patients with Bulimic Disorders with low levels of interpersonal problems and high levels of low self-esteem are likely to do less well with IPT, different type of treatment should be offered to them. A randomized controlled trial could explore this hypothesis in more detail.

A case series evaluation of a modified version of interpersonal psychotherapy (IPT) for the treatment of bulimic eating disorders: a pilot study.

OBJECTIVE: To determine the therapeutic outcome of a modified form of (IPT-BNm) amongst patients with Bulimia Nervosa (BN) and Eating Disorders Not Otherwise Specified (EDNOS). METHOD: Following initial assessment, 59 patients with diagnoses of BN or EDNOS entered treatment in the form of 16 sessions of IPT-BNm. At initial assessment, patients completed measures of general psychopathology (SCL-90), Self esteem (RSE), eating psychopathology (EDE-Q), interpersonal functioning (Inventory of Interpersonal Functioning; IIP-32) and depression (BDI). At the middle and end of treatment, EDE-Q, IIP-32 and BDI measures were repeated. RESULTS: By the middle of therapy, patients had made significant improvements in terms of their eating disordered cognitions and behaviours (including reductions in EDE-Q scores, bingeing and self-induced vomiting), interpersonal functioning and levels of depression. CONCLUSIONS: IPT-BNm is an effective treatment for patients with Bulimic Eating Disorders and appears to work quickly, as there were significant reductions in eating disorders symptoms within the first eight sessions of treatment.

A dialectical behavior therapy program for people with an eating disorder and borderline personality disorder--description and outcome.

OBJECTIVE: To describe and evaluate a full dialectical behavior therapy (DBT) program for people with comorbid eating disorder and borderline personality disorder. The program included a novel skills training module written especially for eating-disordered patients. METHOD: The program was run for 18 months. Days in hospital and major acts of self-harm were counted for the 18 months before and after DBT. RESULTS: There were no dropouts from the program. The patients seemed to benefit. Most patients were neither eating disordered nor self-harming at follow-up. DISCUSSION: Full DBT is an expensive and demanding treatment but deserves consideration for patients with an eating disorder and co-morbid borderline personality disorder and self-harm. There is a need for a more systematic and thorough evaluation.

Self-help for bulimic disorders: a randomised controlled trial comparing minimal guidance with face-to-face or telephone guidance.

BACKGROUND: There is great potential demand for treatment of bulimia nervosa and binge eating disorder. Skilled therapists are in short supply. Self-help and guided self-help based upon books have shown some promise as an economical alternative to full therapy in some cases. AIMS: To investigate the efficacy and effectiveness of self-help with and without guidance in a specialist secondary service. METHOD: A randomised controlled trial comparing three forms of self-help over 4 months with a waiting-list comparison group and measurement of service consumption over the subsequent 8 months. RESULTS: Self-help delivered with four sessions of face-to-face guidance led to improved outcome over 4 months. There is also some evidence to support the use of telephone guidance. A minority of participants achieved lasting remission of their disorder in relation to self-help, but there was no significant difference in final outcome between the groups after they had progressed through the stepped care programme. Patients initially offered guided self-help had a lower long-term drop-out rate. CONCLUSIONS: Guided self-help is a worthwhile initial response to bulimia nervosa and binge eating disorder. It is a treatment that could be delivered in primary care and in other non-specialist settings.