A comparison of nutritional management with stress management in the treatment of bulimia nervosa.

Division of Psychoneuroendocrinology, Max Planck Institute for Psychiatry, Munich.
The British Journal of Psychiatry (Impact Factor: 7.34). 09/1991; 159:250-61. DOI: 10.1192/bjp.159.2.250
Source: PubMed

ABSTRACT In a comparison of nutritional management (NM) and stress management (SM) for treatment of bulimia nervosa, 55 female patients were randomly assigned to either treatment. Therapy consisted of 15 sessions in a group over three months, by the end of which, patients under both treatment conditions showed a significant reduction in the frequency of binge eating and vomiting and a significant improvement in various psychopathological features such as body dissatisfaction and depression. All improvements were maintained over 12-month follow-up NM produced a more rapid improvement in general eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating. SM led to greater positive changes in certain psychopathological features such as feelings of ineffectiveness, interpersonal distrust and anxiety. NM should be regarded as a necessary first intervention in all bulimic patients. Further psychological therapy, such as SM, is indicated as well for some patients, depending on their specific psychological difficulties.

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