Success of Treatments for Anorexia Nervosa May Change Over time

A review of three types of treatment for anorexia nervosa (AN) five years after the end of treatment has shown that the effectiveness changed over time. Virginia V. W. McIntosh, PhD, a clinical psychologist at the University of Otago, Christchurch, New Zealand, revisited patients from her original 2005 study to study the effectiveness of the treatments over time (Am J Psychiatry. 2005;162:741). When she and her team measured adherence with a modified version of the Collaborative Study Psychotherapy Rating Scale, the rating for the most successful treatment had changed. In the original study, 56 patients with AN were randomly treated with cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), or specialist supportive clinical management (SSCM). The primary focus of SSCM for patients with AN is the resumption of normal eating and the restoration of weight. At the end of treatment, SSCM was superior to both CBT and IPT. However, 5 years later, when 80% of the original group was re-evaluated, the most effective therapy was now IPT. The results were a little worse for CBT, and the ratings were lowest for SSCM.

Dr. McIntosh noted that the small sample size, different characteristics of patients with and without follow-up and life events during the intervening years, may have influenced the results.