RAPID RESPONDERS TO INTENSIVE TREATMENT OF BULIMIA-NERVOSA

Objective: The purpose of the study was to examine patterns of respons e to treatment in bulimia nervosa and to consider the utility of diffe rentiating rapid from slower responders. Method: Participants were 166 female patients with bulimia nervosa who received specialized day hos pital treatment for their eating disorder and provided complete data o n symptom frequencies over the course of treatment. Symptoms and psych ological functioning were assessed at the beginning and end of treatme nt and 2-year follow-up information was available for a subsample of 5 7 patients. Results: A large subgroup (47%) of patients responded rapi dly to treatment (i.e., symptom frequencies of three or less during th e first 4 weeks of treatment) and a smaller subgroup (31%) were consid ered slower responders (i.e., symptom frequencies of four or more over the first 4 weeks of treatment and three or less over the last 4 week s of treatment). The remaining patients were either partial responders (18%) or nonresponders (10%). Rapid responders tended to be older, le ss symptomatic, and less preoccupied with binging before treatment (al l ps < .05), but the differences were not strong. Rapid responders als o had better symptom control at the end of treatment (p < .00001), wer e less likely to receive antidepressant/antibulimic medication during the program (p < .04), and were significantly less likely to relapse w ithin 2 years of attending the program (p < .005). Discussion: These f indings demonstrate that a significant subgroup of severely ill bulimi a nervosa patients had a rapid, strong, and enduring response to inten sive treatment, but could not be well identified with the available me asures before treatment. (C) 1996 by John Wiley & Sons, Inc.