The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication

The detection of psychiatric illness by questionnaire

http://ny-dbt-rmphd.weebly.com/uploads/3/0/5/9/30590917/cbt-e_article_fairburn_1_.pdf

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment.

Objective:To present nationally representative data on 12-month and lifetime prevalence, correlates, and comorbidity of DSM-IV major depressive disorder (MDD) among adults in the United States. Design/Setting/Participants:Face-to-face survey of more than 43000 adults aged 18 years and older residinginhouseholdsandgroupquartersintheUnitedStates. Main Outcome Measures: Prevalence and associationsofMDDwithsociodemographiccorrelatesandAxis I and II disorders. Results:Theprevalenceof12-monthandlifetimeDSM-IV MDD was 5.28% (95% confidence interval, 4.98-5.57) and 13.23% (95% confidence interval, 12.64-13.81), respectively. Being female; Native American; middleaged; widowed, separated, or divorced; and low income increased risk, and being Asian, Hispanic, or black decreased risk (P.05). Women were significantly more likely to receive treatment than men. Both current and lifetimeMDDweresignificantlyassociatedwithotherspecific psychiatric disorders, notably substance dependence, panic and generalized anxiety disorder, and several personality disorders. Conclusions:This large survey suggests a higher prevalence of MDD in the US population than large-sample estimates from the 1980s and 1990s. The shift in highest lifetime risk from young to middle-aged adults is an important transformation in the distribution of MDD in the United States and specificity in risk for an ageperiodcohort.AssociationsbetweenMDDandAxisIand II disorders were strong and significant, with variation within broad categories by specific diagnoses signaling the need for attention to the genetic and environmental reasons for such variation, as well as the implications for treatment response. Arch Gen Psychiatry. 2005;62:1097-1106

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Epidemiology of Major Depressive Disorder: Results From the National Epidemiologic Survey on Alcoholism and Related Conditions

/pdf/practice-guideline-for-the-treatment-of-patients-with-major-ofberaz3o1.pdf

PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder

Method: Fifty-six women with anorexia nervosa diagnosed by using strict and lenient weight criteria were randomly assigned to three treatments. Two were specialized psychotherapies (cognitive behavior therapy and interpersonal psychotherapy), and one was a control treatment combining clinical management and supportive psychotherapy (nonspecific supportive clinical management). Therapy consisted of 20 sessions over a minimum of 20 weeks. Results: For the total study group (intentto-treat group), there were significant differences among therapies in the primary global outcome measure. Nonspecific supportive clinical management was superior to interpersonal psychotherapy, while cognitive behavior therapy was intermediate, neither worse than nonspecific supportive clinical management nor better than interpersonal psychotherapy. For the women completing therapy, nonspecific supportive clinical management was superior to the two specialized therapies. Conclusions: The finding that nonspecific supportive clinical management was superior to more specialized psychotherapies was opposite to the primary hypothesis and challenges assumptions about the effective ingredients of successful treatments for anorexia nervosa.

http://dogsbody.psych.mun.ca/~jcarter/6602/Psych%206602%20Winter%202014/Week%208/McIntosh%20et%20al%202005.pdf

Three psychotherapies for anorexia nervosa: a randomized, controlled trial.

Objective: We explored anorexic patients' subjective accounts of the causes of their anorexia and of the factors that fostered recovery. Subjective accounts could assist in understanding this complicated and often intractable disorder. Method: All female new referrals to an eating disorders service underwent extensive interviews including open- ended questions about their beliefs concerning the causes of their anorexia nervosa and factors that led to recovery. Responses were categorized by two independent raters. Results: The most commonly mentioned perceived causes were dysfunctional families, weight loss and dieting, and stressful experiences and perceived pressure. The three most commonly cited factors contributing to recovery were supportive nonfamilial relationships, therapy, and maturation. Discussion: Individuals with anorexia nervosa perceive both external (family environment) and personal factors (dieting and stress) as contributory to their disorders. The results underscore the importance of interpersonal factors in recovery from anorexia nervosa and suggest that attention to this area in treatment may be beneficial. # 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 143-154, 2003.

/pdf/causes-and-recovery-in-anorexia-nervosa-the-patient-s-2b5nrxbrnm.pdf

Causes and recovery in anorexia nervosa: the patient's perspective.

Background Interpersonal psychotherapy and cognitive–behavioural therapy (CBT) are established as effective treatments for major depression. Controversy remains regarding their effectiveness for severe and melancholic depression.

Aims To compare the efficacy of interpersonal psychotherapy and CBT in people receiving out-patient treatment for depression and to explore response in severe depression (Montgomery–Asberg Depression Rating Scale (MADRS) score above 30), and in melancholic depression.

Method Randomised clinical trial of 177 patients with a principal Axis I diagnosis of major depressive disorder receiving 16 weeks of therapy comprising 8–19 sessions. Primary outcome was improvement in MADRS score from baseline to end of treatment.

Results There was no difference between the two psychotherapies in the sample as a whole, but CBT was more effective than interpersonal psychotherapy in severe depression, and the response was comparable withthatfor mild and moder-ate depression. Melancholia did not predictpoor response to either psychotherapy.

Conclusions Both therapies are equally effective for depression but CBT may be preferred in severe depression.

/pdf/randomised-controlled-trial-of-interpersonal-psychotherapy-516enezipi.pdf

Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression.

Objective:
To evaluate the long-term efficacy of three psychotherapies for anorexia nervosa.

Method:
Participants were women with broadly defined anorexia nervosa who had participated in a RCT comparing specialized psychotherapies (cognitive behavior therapy, CBT, and interpersonal psychotherapy, IPT) with a control condition (specialist supportive clinical management, SSCM), and attended long-term follow-up assessment (mean 6.7 years ± 1.2).

Results:
Forty three of the original sample of 56 women participated in long-term follow-up assessment (77%). No significant differences were found on any pre-selected primary, secondary or tertiary outcome measures among the three psychotherapies at long-term follow-up assessment. Significantly different patterns of recovery were identified for the psychotherapies across time on the primary global outcome measure. Although SSCM was associated with a more rapid response than IPT, by follow-up all three treatments were indistinguishable.

Discussion:
Potential implications for the timing of interventions to improve treatment response in anorexia nervosa are critically examined. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010

https://www.onlinelibrary.wiley.com/doi/pdf/10.1002/eat.20879

The long-term efficacy of three psychotherapies for anorexia nervosa: a randomized, controlled trial.

This study compares rates of comorbidity of lifetime psychiatric disorder in a clinical sample of women with bulimia, with general population base rates, and with rates of comorbidity among bulimic women in the general population. Eighty-four per cent of the clinical sample of bulimic women had a lifetime affective disorder, and 44% a lifetime alcohol or drug disorder. These rates of disorder were significantly higher than the base rates in the general population. Bulimic women in the general population also had more affective and substance-use disorders than the general population base rates, but the rates of these disorders were lower than found in the clinical sample. In the general population, quite similar rates of other disorders including generalized anxiety, panic, phobia and obsessive-compulsive disorder, are found among those with bulimia, substance-use disorder and depression. Furthermore, among those with depression and substance-use disorder in the general population, rates of eating disorder are comparable. Rather than suggesting a specific relationship between bulimia and either depression or substance-use disorder, the data from this study suggest that the presence of any disorder is associated with a non-specific increase in the likelihood of other psychiatric disorder.

Janice M. McKenzie

Papers

Three psychotherapies for anorexia nervosa: a randomized, controlled trial.

Causes and recovery in anorexia nervosa: the patient's perspective.

Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression.

The long-term efficacy of three psychotherapies for anorexia nervosa: a randomized, controlled trial.

Bulimia comorbidity in the general population and in the clinic