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“The effects of psychotherapy: an evaluation”.

Many randomized, controlled trials have examined psychological therapies for adults with eating disorders, most commonly bulimia nervosa. Cognitive behavior therapy has been established as the treatment of choice for bulimia nervosa (1). Interpersonal psychotherapy may also be an effective treatment in this group (2), although improvement is less rapid than with cognitive behavior therapy. There is evidence that these specialized psychotherapies are superior to other forms of psychotherapy (3). Anorexia nervosa is a serious illness with substantial morbidity (4) and a mortality rate of approximately 5% per decade (5). Outpatient therapies are widely used in its treatment. However, few randomized, controlled trials have examined treatments for anorexia nervosa. Favorable results have been achieved by using family-based interventions with adolescents (6, 7). While some studies with adults have shown that specialized psychotherapies are superior to no treatment (8) or to a control condition of “routine” treatment (9), others have found no difference between two or more treatments (10, 11). The specific therapies studied include cognitive behavior therapy (11, 12), focal psychoanalytic psychotherapy (9), cognitive analytic therapy (9, 10), dietary counseling (12, 13), individual supportive therapy (14), and family therapy (9, 14). Taken together, these studies have not demonstrated clear superiority of any specific therapy for anorexia nervosa.