ARTICLES
Comparison of Long-Term Outcomes in Adolescents With Anorexia Nervosa Treated With Family Therapy

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ABSTRACT

Objective

To describe the relative effectiveness of a short versus long course of family-based therapy (FBT) for adolescent anorexia nervosa at long-term follow-up.

Method

This study used clinical and structured interviews to assess psychological and psychosocial outcomes of adolescents (ages 12-18 years at baseline) who were previously treated in a randomized clinical trial using family therapy between 1999 and 2002.

Results

Eighty-three percent (71/86) of subjects participated in follow-up assessments of current psychological and psychosocial functioning. In addition, 49% (35) were interviewed using the Eating Disorder Examination. Mean length of follow-up was 3.96 years (range 2.3-6.0 years). There were no statistically significant differences between the two groups on any measure at long-term follow-up. As a whole, the group was doing well with 89% above 90% ideal body weight, 74% with Eating Disorder Examination scores within the normal range, and 91% of postmenarcheal females not on birth control had menstrual return.

Conclusions

A short course of family therapy is as effective as a longer course at follow-up.

Section snippets

Participants and Procedure

In the original study, subjects and families were randomly assigned for treatment with manual-based family therapy for 6 or 12 months (Lock et al., 2005). Efficacy was compared at the end of 1 year by examining primary outcomes of body mass index (BMI) and global Eating Disorder Examination (EDE) score. Eighty-six subjects were involved in this study, ranging in age from 12 to 18 years. All of the subjects were diagnosed with AN by DSM-IV criteria with the exception that for those subjects who

RESULTS

In this follow-up study, 86% (74/86) of the subjects were contacted. Three refused to participate. This resulted in a sample size of 71 (83%) subjects, of whom 35 (49%) completed EDEs. Information was largely obtained through the subjects themselves and through parents (Table 1). Mean length of follow-up was 3.96 years (range 2.3-6.0), and the mean age of subjects was 19.2 years (range 15.5-23.2) at the time of follow-up.

DISCUSSION

Our hypothesis that there would be no differences between the short and long versions of family treatment at long-term follow-up was supported by the findings of this study. No statistical differences were detected between the two groups at a mean of almost 4 years after the end of treatment. Furthermore, there was no evidence of increased treatment utilization by the shorter-term treatment group in terms of psychotherapy, medication, or hospitalization. Thus, it is reasonable to conclude that

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Dr. Lock's efforts on this research was supported by National Institute of Health grant numbers K08 MH1457 and K24 MH074467 . The authors acknowledge the support of Susan Bryson, M.A., and Judy Beenhaker.

Disclosure: Dr. Lock receives royalties from the sale of his coauthored book Treatment Manual for Anorexia Nervosa: A Family-Based Approach (The Guilford Press, 2001). The other authors have no financial relationships to disclose.

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