@article{ref1,
title="Patients with bulimia nervosa who fail to engage in cognitive behavior therapy",
journal="International journal of eating disorders",
year="1993",
author="Coker, S. and Vize, C. and Wade, T. and Cooper, P. J.",
volume="13",
number="1",
pages="35-40",
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.<p /><p>Language: en</p>",
language="en",
issn="0276-3478",
doi="10.1002/1098-108x(199301)13:1<35::aid-eat2260130105>3.0.co;2-n",
url="http://dx.doi.org/10.1002/1098-108x(199301)13:1<35::aid-eat2260130105>3.0.co;2-n"
}