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Cognitive-behavioural, fluoxetine and combined treatment for bulimia nervosa: short- and long-term results

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This study examined the short- and long-term effectiveness of cognitive-behavioural group treatment (CBT), pharmacological treatment with fluoxetine and combined treatment in patients with DSM-III-R bulimia nervosa. Fifty-three patients were randomly assigned to the three conditions. Outcome measures were frequency of bingeing and purging, attitudes toward weight and shape, depression and self-concept. Patients were followed for 1 year post-treatment. Thirty-five patients completed treatment. Drop-out rates were 42 per cent for CBT, 25 per cent for the fluoxetine and 33 per cent for the combined condition. All treatments led to significant improvements in eating disorder symptoms and in other psychological disturbances between pre- and post-treatment, which could be maintained at 1-year follow-up. Abstinence rates for completers were highest for CBT at both post-treatment and follow-up. The short- and long-term results of this study do not favour the combined treatment in comparison to CBT alone. Cultural differences in health systems as well as in the acceptance of treatments offered in a treatment trial are discussed. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.

Keywords: CBT; bulimia nervosa; combined treatment; fluoxetine

Document Type: Research Article


Affiliations: 1: Psychogical Institute III, University of Hamburg, Germany 2: Psychosomatic Department, Children's Hospital, University of Hamburg: Neuroscience Division, Medical Department, Lilly Deutschland GmbH, Bad Homburg, Germany

Publication date: May 1, 2002

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