Family Therapy for Adolescent Bulimia Nervosa

Family Therapy for Adolescent Bulimia Nervosa: A Controlled Comparison

The primary hypotheses are:

• A procedurally distinct family therapy is an effective and essential way to reduce bingeing and purging in adolescents with BN, and leads to the long-term amelioration of bulimic symptoms.
• Family therapy is an effective way to bring about meaningful improvements in family interaction.
• Family therapy will produce significantly larger reductions in bulimic symptoms and improved family interaction in adolescents with BN compared to a control supportive psychotherapy.

Study Overview

• Status: Completed
• Conditions: Bulimia Nervosa
• Intervention / Treatment: Behavioral: FBT-BN; Behavioral: SPT

Detailed Description

Bulimia nervosa (BN) is a disabling eating disorder and affects as many as 2% of young women. It is a major source of psychiatric and medical morbidity that often impairs several areas of functioning. Even more alarming is the fact that BN is occurring with increasing frequency among adolescents and preadolescents. Applying stringent diagnostic criteria for BN, studies have found 2-5% of adolescent girls surveyed qualify for diagnosis of BN. Research specific to treatment of child and adolescent eating disorders remains limited. No psychological treatment has been systematically evaluated in the treatment of adolescents with BN. However, a series of studies from the Maudsley Hospital in London have shown that family therapy (the 'Maudsley Approach') is effective in the treatment of adolescents with anorexia nervosa (AN). These studies have shown that involving the parents and siblings in treatment has beneficial effects on reversing the course of the eating disorder as well as improving family interaction. A preliminary report from the Maudsley group has also shown that the 'Maudsley Approach' may be helpful in the treatment of adolescents with BN. Because most young adolescents still live with their families of origin, this raises the interesting clinical question that adolescent BN patients can also be successfully treated with family therapy.

The proposed study has two specific aims:

1. To adapt and pilot a recently developed family therapy manual for adolescent AN for use in the treatment of adolescent BN patients.
2. To compare the efficacy of this conceptually and procedurally distinct family therapy treatment with individual control psychotherapy.

To achieve these aims, we propose a five-year controlled treatment study to be carried out at The University of Chicago. Eighty newly referred adolescent patients meeting DSM-IV diagnostic criteria for BN will be randomly allocated to one of two groups: 1) family therapy or 2) the individual supportive control treatment. All patients will receive the same medical evaluation and monitoring throughout the study period. Assessment of psychiatric and medical outcome measures will be carried out at the onset of treatment, during treatment, at the end of treatment, and again at one-year follow-up. The clinical outcome variables assessed will include the EDE, KSADS, RSE, and EE.

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60637
      • The University of Chicago

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 15 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• DSM-IV criteria for bulimia nervosa or partial bulimia nervosa

Exclusion Criteria:

• psychotic illness acute suicidality medical illness that impacts weight pregnant

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: FBT-BN; Family-based treatment	Behavioral: FBT-BN; Mobilizing parents to curtail binge eating and purging
Active Comparator: SPT; Individual Supportive Psychotherapy	Behavioral: SPT; Supportive the individual patient to explore factors that might underlie the eating disorder

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Binge eating and purging frequency measured by the Eating Disorder Examination	28 days

Secondary Outcome Measures

Outcome Measure	Time Frame
EDE Subscales	28 days

Collaborators and Investigators

• Sponsor: University of Chicago
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Daniel Le Grange, PhD, The University of Chiacgo

Study record dates

Study Major Dates

• Study Start: April 1, 2001
• Primary Completion (Actual): May 1, 2006
• Study Completion (Actual): May 1, 2006

Study Registration Dates

• First Submitted: August 17, 2007
• First Submitted That Met QC Criteria: August 17, 2007
• First Posted (Estimate): August 21, 2007

Study Record Updates

• Last Update Posted (Estimate): September 5, 2013
• Last Update Submitted That Met QC Criteria: September 4, 2013
• Last Verified: September 1, 2013

More Information

Terms related to this study

• Keywords: binge eating; purging
• Additional Relevant MeSH Terms: Mental Disorders; Signs and Symptoms, Digestive; Feeding and Eating Disorders; Hyperphagia; Bulimia; Bulimia Nervosa
• Other Study ID Numbers: 10208 (K23 MH01923)