Psychological therapies for adults with anorexia nervosa - Randomised controlled trial of out-patient treatments

Background Currently,without systematic evidence, psychotherapy for anorexia nervosa in adults draws on psychodynamic, cognitive and systemic theories. Aims To assess effectiveness of specific psychotherapies in out-patient management of adult patients with anorexia nervosa. Method Eighty-four patients were randomised to four treatments: three specific psychotherapies - (a) a year of focal psychoanalytic psychotherapy; (b)7 months of cognitive -analytic therapy (CAT); (c) family therapy for 1 year - and (d) low contact, 'routine' treatment for 1 year (control). Results At 1 year,there was symptomatic improvement in the whole group of patients. this improvement was modest, several patients being significantly undernourished at follow-up. Psychoanalytic psychotherapy and family therapy were significantly superior to the control treatment; CAT tended to show benefits. Conclusions Psychoanalytic and family therapy are of specific value in the out-patient treatment of adult patients with anorexia. Declaration of interest Research support comes from the Leverhulme Foundation and the Menial Health Research Fund.