Citation

Coker S, Vize C, Wade T, Cooper PJ. Int. J. Eat. Disord. 1993; 13(1): 35-40.

Copyright

(Copyright © 1993, John Wiley and Sons)

DOI

10.1002/1098-108x(199301)13:1<35::aid-eat2260130105>3.0.co;2-n

PMID

8477275

Abstract

Although cognitive behavioral treatment is the treatment of choice in bulimia nervosa, patients' response is variable. A minority of patients do not respond at all and some never engage in treatment. This paper concerns the latter group. A case series of six such patients with whom treatment could not be initiated is compared with a group who received a full course of treatment. The group with whom treatment could not begin were found to have a longer history of disorder, to report excessive laxative abuse, to have more severe depressed mood and a greater dissatisfaction with their body weight. In addition, they were more likely to have abused psychoactive substances, engaged in episodes of self-harm, and have a lower self-esteem. They were also more likely to be diagnosed as having borderline personality disorder. Patients presenting with the wide range of difficulties characteristic of this group require a more intensive form of treatment than standard outpatient cognitive behavior therapy.

Language: en

Keywords

Adolescent; Adult; Anorexia Nervosa; Body Image; Body Weight; Bulimia; Cognitive Behavioral Therapy; Diet, Reducing; Female; Humans; Patient Compliance; Patient Dropouts; Substance-Related Disorders