Five-year outcome of cognitive behavioral therapy and exposure with response prevention for bulimia nervosa

2010 ◽  
Vol 41 (5) ◽  
pp. 1061-1071 ◽  
Author(s):  
V. V. W. McIntosh ◽  
F. A. Carter ◽  
C. M. Bulik ◽  
C. M. A. Frampton ◽  
P. R. Joyce
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Bulimia Nervosa ◽  
Relaxation Training ◽  
Behavioral Therapy ◽  
Response Prevention ◽  
Cognitive Behavioral ◽  
Term Outcome ◽  
Definition Of

BackgroundFew data exist examining the longer-term outcome of bulimia nervosa (BN) following treatment with cognitive behavioral therapy (CBT) and exposure with response prevention (ERP).MethodOne hundred and thirty-five women with purging BN received eight sessions of individual CBT and were then randomly assigned to either relaxation training (RELAX) or one of two ERP treatments, pre-binge (B-ERP) or pre-purge cues (P-ERP). Participants were assessed yearly following treatment and follow-up data were recorded.ResultsEighty-one per cent of the total sample attended long-term follow-up. At 5 years, abstinence rates from binging were significantly higher for the two exposure treatments (43% and 54%) than for relaxation (27%), with no difference between the two forms of exposure. Over 5 years, the frequency of purging was lower for the exposure treatments than for relaxation training. Rates of recovery varied according to definition of recovery. Recovery continued to increase to 5 years. At 5 years, 83% no longer met DSM-III-R criteria for BN, 65% received no eating disorder diagnosis, but only 36% had been abstinent from bulimic behaviors for the past year.ConclusionsThis study provides possible evidence of a conditioned inoculation from exposure treatment compared with relaxation training in long-term abstinence from binge eating at 5 years, and the frequency of purging over 5 years, but not for other features of BN. Differences among the groups were not found prior to 5 years. CBT is effective for BN, yet a substantial group remains unwell in the long term. Definition of recovery impacts markedly on recovery rates.

Role of exposure with response prevention in cognitive-behavioral therapy for bulimia nervosa: Three-year follow-up results

2003 ◽  
Vol 33 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Frances A. Carter ◽  
Virginia V. W. McIntosh ◽  
Peter R. Joyce ◽  
Patrick F. Sullivan ◽  
Cynthia M. Bulik
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Bulimia Nervosa ◽  
Behavioral Therapy ◽  
Response Prevention ◽  
Cognitive Behavioral

Enhanced treatment for depression in primary care: long-term outcomes of a psycho-educational prevention program alone and enriched with psychiatric consultation or cognitive behavioral therapy

2007 ◽  
Vol 37 (6) ◽  
pp. 849-862 ◽  
Author(s):  
HENK JAN CONRADI ◽  
PETER de JONGE ◽  
HERMAN KLUITER ◽  
ANNET SMIT ◽  
KLAAS van der MEER ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Psychiatric Consultation ◽  
Term Outcome ◽  
Long Term Outcome

Background. The long-term outcome of major depression is often unfavorable, and because most cases of depression are managed by general practitioners (GPs), this places stress on the need to improve treatment in primary care. This study evaluated the long-term effects of enhancing the GP's usual care (UC) with three experimental interventions.Method. A randomized controlled trial was conducted from 1998 to 2003. The main inclusion criterion was receiving GP treatment for a depressive episode. We compared: (1) UC (n=72) with UC enhanced with: (2) a psycho-educational prevention (PEP) program (n=112); (3) psychiatrist-enhanced PEP (n=37); and (4) brief cognitive behavioral therapy followed by PEP (CBT-enhanced PEP) (n=44). We assessed depression status quarterly during a 3-year follow-up.Results. Pooled across groups, depressive disorder-free and symptom-free times during follow-up were 83% and 17% respectively. Almost 64% of the patients had a relapse or recurrence, the median time to recurrence was 96 weeks, and the mean Beck Depression Inventory (BDI) score over 12 follow-up assessments was 9·6. Unexpectedly, PEP patients had no better outcomes than UC patients. However, psychiatrist-enhanced PEP and CBT-enhanced PEP patients reported lower BDI severity during follow-up than UC patients [mean difference 2·07 (95% confidence interval (CI) 1·13–3·00) and 1·62 (95% CI 0·70–2·55) respectively] and PEP patients [2·37 (95% CI 1·35–3·39) and 1·93 (95% CI 0·92–2·94) respectively].Conclusions. The PEP program had no extra benefit compared to UC and may even worsen outcome in severely depressed patients. Enhancing treatment of depression in primary care with psychiatric consultation or brief CBT seems to improve the long-term outcome, but findings need replication as the interventions were combined with the ineffective PEP program.

Group cognitive-behavioral therapy for insomnia (CBT-I): long-term follow-up evaluation

2017 ◽  
Vol 40 ◽  
pp. e302
Author(s):  
M. Sforza ◽  
M. Poletti ◽  
L. Giarolli ◽  
A. Galbiati ◽  
S. Marelli ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Long Term Follow Up

Long Term Effect of Cognitive Behavioral Therapy in Patients with Health Anxiety

2017 ◽  
Vol 41 (S1) ◽  
pp. S111-S112
Author(s):  
K.E. Veddegjaerde
Keyword(s):  
Quality Of Life ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Health Anxiety ◽  
Term Effect ◽  
Cognitive Behavioral ◽  
Long Term Effect

IntroductionCognitive-behavioral therapy (CBT) has been found to be an effective treatment of excessive health anxiety (HA), but the long-term effect over 18months has not been examined.ObjectivesSeveral studies have shown effect of CBT for HA-patients. However, these effects have been short or immediate after therapy. To our knowledge no studies have examined long-term effect of CBT for HA over 18 months.AimsTo investigate the long-term effect of CBT on HA, focusing on level of HA, quality of life, subjective health complaints and general anxiety. Follow-up time was at least 10 years. Our hypothesis was that the effect was sustained.MethodsPatients with HA received 16 sessions of CBT over a period of 12–18 months, and were followed up over at least 10 years. All patients fulfilled criteria for F45.2, hypochondriacal disorder according to ICD-10.The patients answered several questionnaires, exploring areas such as HA, Quality of life, somatization, and mental health problems. Questionnaires were answered before CBT, after CBT and at follow up. Mixed model analysis was performed in SPSS 23.0 for all questionnaires.ResultsAll scores were found to be significant in the Pre-CBT–Post-CBT and Pre-CBT–FU (0.034– < 0.001), and none were found to be significant in the Post-CBT–FU.ConclusionsOur findings suggest that for the majority of patients with HA, CBT has a significant and lasting long-term effect. This effect lasts up to ten years post therapy.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Long-Term Effectiveness of Cognitive Behavioral Therapy in Routine Outpatient Care: A 5- to 20-Year Follow-Up Study

2019 ◽  
Vol 88 (4) ◽  
pp. 225-235 ◽  
Author(s):  
Ruth von Brachel ◽  
Gerrit Hirschfeld ◽  
Arleta Berner ◽  
Ulrike Willutzki ◽  
Tobias Teismann ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Outpatient Care ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Follow Up Study
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