Maintenance treatment for anorexia nervosa: A comparison of cognitive behavior therapy and treatment as usual

2009 ◽  
Vol 42 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Jacqueline C. Carter ◽  
Traci L. McFarlane ◽  
Carmen Bewell ◽  
Marion P. Olmsted ◽  
D. Blake Woodside ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Maintenance Treatment ◽  
Cognitive Behavior ◽  
Treatment As Usual

scholarly journals The effect of group cognitive behavior therapy on Chinese patients with anorexia nervosa: an open label trial

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Lian Gu ◽  
Yunling Zou ◽  
Yue Huang ◽  
Qiang Liu ◽  
Han Chen ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Weight Regain ◽  
Symptom Improvement ◽  
Cognitive Behavior ◽  
Open Label ◽  
Cost Of Treatment ◽  
Open Label Trial

Abstract Background The high cost of treatment for anorexia nervosa (AN) and lack of trained specialists have resulted in limited accessibility of effective treatment to patients with AN, which is particularly problematic in China. To increase the accessibility of evidence-based treatment and reduce the cost of treatment, this study aimed to explore the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy for eating disorders (CBT-E) in Chinese AN patients. Method A total of 78 patients with AN were assigned to G-CBT or individual outpatient treatment (IOT) and received three months of treatment for AN in each condition. Measures of eating pathology, depression and anxiety were administrated to both intervention groups at three time points: baseline, one month of treatment, and end of treatment; results were compared between groups and over time. Results There were 70 participants included in the final analysis. Both G-CBT and IOT groups showed significant improvement in eating pathology and associated psychopathology (ps < .001) over the course of treatment, but no significant difference in symptom improvement was found between the two groups (ps > .05). G-CBT resulted in additional significant improvement in ED psychopathology over the last two months of treatment, and its overall therapeutic effect was influenced by baseline weight and early symptom improvement. Conclusion Preliminary findings from this open label trial suggest that G-CBT adapted from CBT-E is feasible in an outpatient setting and as effective as IOT in facilitating weight regain and reducing psychopathology in Chinese AN patients with little evidence for the superiority of either intervention. Trial registration: The current study was registered at clinical trials.gov on September 23, 2018 (registration number NCT03684239). Plain English summary People with anorexia nervosa (AN) are known to be unmotivated for treatment and prone to relapse. Recovery from AN often needs intensive, long-term treatment from a specialized multidisciplinary team, which is not accessible for most people in China. Given the increasing incidence of AN and lack of eating disorder (ED) specialists in China, it is important to develop short-term cost-effective treatments for AN. In this study, we explored the feasibility and efficacy of group cognitive behavior therapy (G-CBT) adapted from enhanced cognitive behavior therapy (CBT-E) for people with AN from China. We found that G-CBT was as effective as individual outpatient treatment (IOT) typically provided to AN patients at the research site in facilitating weight regain, improving eating behaviors, and reducing ED and other symptoms. We also found that patients receiving G-CBT made more improvements in cognitive symptoms of the ED, which might help maintain treatment gains and prevent relapse in the long run. This potential long-term advantage of G-CBT needs to be verified in long-term follow-up.

Randomized Controlled Clinical Effectiveness Trial of Cognitive Behavior Therapy Compared With Treatment As Usual for Persistent Insomnia in Patients With Cancer

2008 ◽  
Vol 26 (28) ◽  
pp. 4651-4658 ◽  
Author(s):  
Colin A. Espie ◽  
Leanne Fleming ◽  
James Cassidy ◽  
Leslie Samuel ◽  
Lynne M. Taylor ◽  
...  
Keyword(s):  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Gynecological Cancer ◽  
Clinical Effectiveness ◽  
Effect Sizes ◽  
Sleep Diary ◽  
Cognitive Behavior ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Time In Bed

Purpose Persistent insomnia is a common complaint in cancer survivors, but is seldom satisfactorily addressed. The adaptation to cancer care of a validated, cost-effective intervention may offer a practicable solution. The aim of this study was to investigate the clinical effectiveness of protocol-driven cognitive behavior therapy (CBT) for insomnia, delivered by oncology nurses. Patients and Methods Randomized, controlled, pragmatic, two-center trial of CBT versus treatment as usual (TAU) in 150 patients (103 females; mean age, 61 years.) who had completed active therapy for breast, prostate, colorectal, or gynecological cancer. The study conformed to CONSORT guidelines. Primary outcomes were sleep diary measures at baseline, post-treatment, and 6-month follow-up. Actigraphic sleep, health-related quality of life (QOL), psychopathology, and fatigue were secondary measures. CBT comprised five, small group sessions across consecutive weeks, after a manualized protocol. TAU represented normal clinical practice; the appropriate control for a clinical effectiveness study. Results CBT was associated with mean reductions in wakefulness of 55 minutes per night compared with no change in TAU. These outcomes were sustained 6 months after treatment. Standardized relative effect sizes were large for complaints of difficulty initiating sleep, waking from sleep during the night, and for sleep efficiency (percentage of time in bed spent asleep). CBT was associated with moderate to large effect sizes for five of seven QOL outcomes, including significant reduction in daytime fatigue. There was no significant interaction effect between any of these outcomes and baseline demographic, clinical, or sleep characteristics. Conclusion CBT for insomnia may be both clinically effective and feasible to deliver in real world practice.

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