Preliminary Results of a Comparison Treatment Trial of Bulimia Nervosa

Abstract

Recent treatment research on bulimia nervosa and bulimia has focused on the use of two types of therapy: drug therapy, particularly antidepressant therapy, and psychotherapy, particularly psychotherapies employing cognitive behavioral techniques. Beginning with the controlled trial of imipramine published by Pope et al. in 1983, several placebo-controlled, double-blind trials have been reported, and most show significant advantages for active drug over placebo in terms of improvement in eating symptoms, depressive symptoms, or both (Mitchell and Groat 1984; Walsh et al. 1984; Hughes et al. 1986; Agras et al. 1987). The only negative trial involved the use of mianserin at a dosage which may have been inadequate (Sabine et al. 1983). Psychotherapy approaches also have been suggested and evaluated experimentally, several using a group therapy format (Connors et al. 1984; Yates and Sambrailo 1984; Kirkley et al. 1985; Ordman and Kirschenbaum 1985; Lee and Rush 1986; Wilson et al. 1986), one using an individual approach (Fairburn et al. 1986), and the rest using either mixed individual-group techniques or comparing various formats (Lacey 1983; Freeman et al. 1985; Wolchik et al. 1986). The controls in these experiments have varied, a few using waiting list controls, a few using alternative treatments, and a few comparing strategies which vary in some but not all treatment components. These psychotherapy trials have demonstrated efficacy for psychotherapy compared with the controls employed.