FIRST STEP IN MANAGING BULIMIA-NERVOSA - CONTROLLED TRIAL OF THERAPEUTIC MANUAL

Objective-To test the short term efficacy of a self directed treatment manual for bulimia nervosa. Design-Randomised controlled trial of the manual against cognitive behavioural therapy and a waiting list. Sett ing-Tertiary referral centre. Subjects-81 consecutive referrals presen ting with bulimia nervosa or atypical bulimia nervosa. Main outcome me asures-Frequency of binge eating, vomiting, and other behaviours to co ntrol weight as well as abstinence from these behaviours. Results-Cogn itive behavioural treatment produced a significant reduction in the fr equency of binge eating, vomiting, and other behaviours to control wei ght. The manual significantly reduced frequency of binge eating and we ight control behaviours other than vomiting, and there was no change i n the group on the waiting list. Full remission was achieved in five ( 24%) of the group assigned to cognitive behavioural treatment, nine (2 2%) of the group who used the manual, and two (11%) of the group on th e waiting list. Conclusions-A self directed treatment manual may be a useful first intervention in the treatment of bulimia nervosa.