Family Therapy for Adolescent Bulimia Nervosa
Condition: Bulimia Nervosa
MeSH terms: Bulimia; Bulimia Nervosa
Study type: Interventional
Phase: Phase 2

Summary: 
      The primary hypotheses are:

        -  A procedurally distinct family therapy is an effective and essential way to reduce
           bingeing and purging in adolescents with BN, and leads to the long-term amelioration of
           bulimic symptoms.

        -  Family therapy is an effective way to bring about meaningful improvements in family
           interaction.

        -  Family therapy will produce significantly larger reductions in bulimic symptoms and
           improved family interaction in adolescents with BN compared to a control supportive
           psychotherapy.
    

Detailed description: 
      Bulimia nervosa (BN) is a disabling eating disorder and affects as many as 2% of young women.
      It is a major source of psychiatric and medical morbidity that often impairs several areas of
      functioning. Even more alarming is the fact that BN is occurring with increasing frequency
      among adolescents and preadolescents. Applying stringent diagnostic criteria for BN, studies
      have found 2-5% of adolescent girls surveyed qualify for diagnosis of BN. Research specific
      to treatment of child and adolescent eating disorders remains limited. No psychological
      treatment has been systematically evaluated in the treatment of adolescents with BN. However,
      a series of studies from the Maudsley Hospital in London have shown that family therapy (the
      'Maudsley Approach') is effective in the treatment of adolescents with anorexia nervosa (AN).
      These studies have shown that involving the parents and siblings in treatment has beneficial
      effects on reversing the course of the eating disorder as well as improving family
      interaction. A preliminary report from the Maudsley group has also shown that the 'Maudsley
      Approach' may be helpful in the treatment of adolescents with BN. Because most young
      adolescents still live with their families of origin, this raises the interesting clinical
      question that adolescent BN patients can also be successfully treated with family therapy.

      The proposed study has two specific aims:

        1. To adapt and pilot a recently developed family therapy manual for adolescent AN for use
           in the treatment of adolescent BN patients.

        2. To compare the efficacy of this conceptually and procedurally distinct family therapy
           treatment with individual control psychotherapy.

      To achieve these aims, we propose a five-year controlled treatment study to be carried out at
      The University of Chicago. Eighty newly referred adolescent patients meeting DSM-IV
      diagnostic criteria for BN will be randomly allocated to one of two groups: 1) family therapy
      or 2) the individual supportive control treatment. All patients will receive the same medical
      evaluation and monitoring throughout the study period. Assessment of psychiatric and medical
      outcome measures will be carried out at the onset of treatment, during treatment, at the end
      of treatment, and again at one-year follow-up. The clinical outcome variables assessed will
      include the EDE, KSADS, RSE, and EE.
    

Intervention name(s): FBT-BN; SPT
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Mobilizing parents to curtail binge eating and purging; Supportive the individual patient to explore factors that might underlie the eating disorder
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: binge eating; purging