Family and Individual Therapy in Anorexia Nervosa: A 5-Year Follow-up

doi:10.1001/archpsyc.1997.01830230063008

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Vol. 54 No. 11, November 1997

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Family and Individual Therapy in Anorexia Nervosa

A 5-Year Follow-up

Ivan Eisler, PhD; Christopher Dare, FRCPsych; Gerald F. M. Russell, MD; George Szmukler, MD; Daniel le Grange, PhD; Elizabeth Dodge, MSc

Arch Gen Psychiatry. 1997;54(11):1025-1030.

Abstract

Background
There is evidence that specific psychological treatments areeffective in patients with eating disorders. Our goal was todetermine by means of a controlled trial whether psychologicaltreatments, previously found to be effective in anorexia nervosa,gave rise to enduring benefits.

Methods
A 5-year follow-up was conducted on Patients who had participatedin a previous trial of family therapy for anorexia and bulimianervosa. Family therapy or individual supportive therapy hadbeen administered to 80 outpatients for 1 year beginning ondischarge from hospital after weight restoration. The 80 patientshad been subdivided into 4 prognostically homogeneous groupsof which 2 turned out to be the most important: patients withearly onset and short history of anorexia nervosa, and patientswith late-onset anorexia nervosa. At the 5-year follow-up, theefficacy of the outpatient therapies was again assessed by themaintenance of weight, and the categories of general outcomeand dimensions of clinical functioning defined by the Morgan-Russellscales.

Results
Significant improvements were found in the group of 80 patientsas a whole, mainly attributable to the natural outcome of anorexianervosa, and most evident in the early onset and short historygroup, as expected. Within 2 of the prognostic groups, significantbenefits attributable to the previous psychological treatmentswere still evident, favoring family therapy for patients withearly onset and short history of anorexia nervosa and favoringindividual supportive therapy for patients with late-onset anorexianervosa.

Conclusions
Much of the improvements found at a 5year follow-up can be attributedto the natural outcome of the illness. Nevertheless, it wasstill possible to detect long-term benefits of psychologicaltherapies completed 5 years previously.

Author Affiliations

From the Insitute of Psychiatry and the Maudsley Hospital, London, England.

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