Intensive enhanced cognitive behavioural therapy for severe and enduring anorexia nervosa: A longitudinal outcome study

Behav Res Ther. 2017 Feb;89:41-48. doi: 10.1016/j.brat.2016.11.006. Epub 2016 Nov 12.


Objective: This study aimed to evaluate short- and long-term outcomes in patients with severe and enduring anorexia nervosa (SE-AN), as compared with those with non SE-AN (NSE-AN), both treated via an inpatient programme based on a "recovery model" approach.

Methods: Sixty-six adult patients with anorexia nervosa (AN) were recruited from among consecutive referrals to a community-based eating disorder clinic offering inpatient enhanced cognitive behavioural therapy for eating disorders (CBT-E). Body mass index (BMI), and Eating Disorder Examination (EDE) and Brief Symptom Inventory (BSI) scores were recorded at admission, at the end of treatment, and at 6- and 12-month follow-ups.

Results: Thirty-two patients (48.5%) were classified as SE-AN (i.e., duration of illness >7 years), and 34 (51.5%) as NSE-AN. During the treatment, both groups displayed similarly large increases in BMI, as well as improvements in eating-disorder and general psychopathology. After discharge minor deterioration did occur, but both NSE-AN and SE-AN groups showed similar rates of 'good BMI outcome' (BM ≥ 18.5; 44.0% and 40.7%, respectively) and 'full response' (BMI ≥ 18.5 and minimal eating-disorder psychopathology; 32.0% and 33.3%, respectively) at 12-month follow-up.

Conclusions: These findings suggest that inpatient CBT-E is well accepted by patients with AN, and could also be a viable and promising treatment for those with SE-AN.

Keywords: Cognitive behavioural therapy; Disease duration; Duration of illness; Inpatient treatment; Severe and enduring anorexia nervosa.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / therapy*
  • Case-Control Studies
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Inpatients / psychology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Time Factors
  • Treatment Outcome
  • Young Adult