Short- or Long-term Family Therapy for Teens with Anorexia Nervosa

Family therapy is often effective for adolescents with anorexia nervosa. But is there an optimal length of treatment?

James Lock, MD, and his colleagues at Stanford University School of Medicine, Stanford, CA, designed a study to determine whether long-term or short-term family therapy is most effective for adolescents with anorexia nervosa (AN) (J Am Acad Child Adolesc Psychiatry 2005;44:632). Eighty-six teenagers with AN, who were 12 to 18 years of age, were randomly assigned to either short-term treatment (10 sessions over 6 months) or long-term treatment (20 sessions over 12 months). At the end of the year all the teens were evaluated with the

Eating Disorder Examination (EDE). The study was conducted between 1999 and 2000.

One group benefited from longer-term therapy

Using an intent-to-treat analysis, Dr. Lock and colleagues found no significant differences between the short-term and long-term treatment groups. Subjects with severe eating-related obsessive-compulsive features or those whose families were not intact were an exception to the rule, and responded best to long-term therapy.

The authors concluded that a short-term course of family therapy seems to be as effective as a long-term course for most teens with short-duration AN. For those with more severe disease, particularly when obsessive-compulsive behavior is present, a longer course of treatment is much more beneficial.