FAMILY AND INDIVIDUAL THERAPY IN ANOREXIA-NERVOSA - A 5-YEAR FOLLOW-UP

Background: There is evidence that specific psychological treatments a re effective in patients with eating disorders. Our goal was to determ ine by means of a controlled trial whether psychological treatments, p reviously found to be effective in anorexia nervosa, gave rise to endu ring benefits. Methods: A 5-year follow-up was conducted on patients w ho had participated in a previous trial of family therapy for anorexia and bulimia nervosa. Family therapy or individual supportive therapy had been administered to 80 outpatients for 1 year beginning on discha rge from hospital after weight restoration. The 80 patients had been s ubdivided into 4 prognostically homogeneous groups of which 2 turned o ut to be the most important: patients with early onset and short histo ry of anorexia nervosa, and patients with late-onset anorexia nervosa. At the 5-year follow-up, the efficacy of the outpatient therapies was again assessed by the maintenance of weight, and the categories of ge neral outcome and dimensions of clinical functioning defined by the Mo rgan-Russell scales. Results: Significant improvements were found in t he group of 80 patients as a whole, mainly attributable to the natural outcome of anorexia nervosa, and most evident in the early onset and short history group, as expected. Within 2 of the prognostic groups, s ignificant benefits attributable to the previous psychological treatme nts were still evident, favoring family therapy for patients with earl y onset and short history of anorexia nervosa and favoring individual supportive therapy for patients with late-onset anorexia nervosa. Conc lusions: Much of the improvements found at a 5-year follow-up can be a ttributed to the natural outcome of the illness. Nevertheless, it was still possible to detect long-term benefits of psychological therapies completed 5 years previously.