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Table 15 Cognitive behavioural therapy for Anorexia Nervosa

From: Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Certainty assessment

Impact

Certainty

Importance

№ of studies

Study design

Risk of bias

Inconsistency

Indirectness

Imprecision

Other considerations

Weight (assessed with: BMI), Psychological symptoms (EDE)

 1

randomised trials

not serious

not serious

not serious

not serious

none

RCT with 11 adolescents and young adults in CBT group compared to 11 in the Behavioural Family Therapy group (age range 13–23). There were no significant differences in terms of weight.

HIGH

CRITICAL

not serious

not serious

not serious

not serious

none

No differences seen in the eating psychopathology on the EDE between treatment groups.

HIGH

CRITICAL

Weight (assessed with: kg), psychological symptoms with EDE

 1

Case Series

very serious a,b

not serious

not serious

not serious

strong association

This was a large case series of 49 adolescents age 13 to 17 years, all female. 40 sessions weekly for 45 min. Weight was significantly increased by an average of 8.6 kg comparing pre to post weight.

VERY LOW

CRITICAL

very serious a,b

not serious

not serious

not serious

strong association

EDE scores were substantially decreased by a score of 2.03 (range 0–6) indicating psychological symptoms were much improved from pre to post treatment.

VERY LOW

CRITICAL

Weight (assessed with: kg), psychological symptoms

 8

Case Reports

very serious a,b

not serious

not serious

not serious

none

8 case reports describing 8 adolescents (7 females, 1 male) with AN treated with CBT. One case had comorbid OCD. Weight improved with treatment. Age range 11.5 to 17 years.

VERY LOW

CRITICAL

very serious a,b

not serious

not serious

not serious

none

Improved EDE scores and EDI scores as well as improved eating behaviours in terms of a reduction in restricted eating.

VERY LOW

CRITICAL

  1. Explanations
  2. ano randomization
  3. bno control condition
  4. Bibliography:
  5. RCT - Ball 2004 [24]
  6. Case Series - Dalle Grave 2013 [96]
  7. Case Reports - Cowdrey 2016 [97], Cooper 1984 [98], Martin-Murcia 2011 [99], Heffner 2002 [100], Scrignar 1971 [101], Fundudis 1986 [102], Ollendick 1979 [103], Wildes 2011 [104]