Cognitive behaviour therapy versus psychoanalytic psychotherapy for bulimia nervosa

ISRCTN ISRCTN63853635
DOI https://doi.org/10.1186/ISRCTN63853635
Secondary identifying numbers 9901684/25-01-0011 (Danish Council for Independent Research, 41470 (Egmont Foundation), 07018005 (Ivan Nielsen Foundation)
Submission date
02/12/2011
Registration date
22/05/2012
Last edited
14/07/2015
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims?
The purpose of the study is to compare two different psychological treatments for the eating disorder Bulimia Nervosa. The aim is to find out which of the two treatments are most helpful to persons with Bulimia Nervosa. In Denmark, eating disorders have traditionally been treated with psychotherapy. More recently, another treatment method known as cognitive behavior therapy has become increasingly used in the treatment of eating disorders. Cognitive behavior therapy is a focused, symptom-oriented treatment method lasting 20 weeks with sessions twice a week for the first three weeks and bi-weekly for the last three weeks. Several studies have demonstrated that cognitive behavior therapy has a beneficial impact on Bulimia Nervosa. Psychotherapy, which comprises weekly sessions over two years, is oriented toward more fundamental aspects of the personality and focuses less directly on the bulimic symptoms. This is considered a promising treatment, however, it has not been researched thoroughly with regard to Bulimia Nervosa. Thus, it is not possible to tell in advance, which of the two methods are the most efficient.

Who can participate?
All in all, 70 persons will participate. To participate you must be diagnosed with Bulimia Nervosa. Furthermore, participants must be available for the whole two-year treatment period. Although it is possible to participate in the study while in psychopharmacological treatment, the study does not apply for persons with serious psychiatric disorders such as for instance severe depression.

What does the study involve?
In addition to participation in the psychotherapeutic treatment, the study involves a number of assessment interviews before beginning treatment as well as 6 and 24 months after beginning treatment. Additionally, participants will be asked to fill out a number of questionnaires every six months for the first three and a half years after beginning treatment and again five years after beginning treatment.

What are the possible benefits and risks of participating?
The benefits of the study are a reduction or end to bulimic symptoms. There are no known negative side effects related to the treatments.

Where is the study run from?
All assessment interviews will be undertaken at the University Clinic, Department of Psychology, University of Copenhagen. Some of the psychotherapeutic treatments will take place at the University Clinic whereas others will take place with psychologists and psychiatrists in private practice in central Copenhagen.

When is the study starting and how long is it expected to run for?
The study begins in November 2004 and will continue to recruit participants until May 2008. Accordingly, we expect the final data of the study to be collected in May 2013.

Who is funding the study?
Danish Research Council for the Humanities and the Egmont Foundation

Who is the main contact?
Heidi Riiber
bulimi@psy.ku.dk
http://psychology.ku.dk/research/bulimia/

Contact information

Prof Stig Poulsen
Scientific

Department of Psychology
University of Copenhagen
Øster Farimagsgade 2A
Copenhagen K
DK-1353
Denmark

Phone +45 (0)35 32 48 00
Email stig.poulsen@psy.ku.dk

Study information

Study designSingle-centre randomised parallel-group clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleCognitive behaviour therapy versus psychoanalytic psychotherapy for bulimia nervosa: a randomised, observer blinded clinical trial
Study objectives1. After 20 weeks of therapy in an intent-to-treat analysis the percentage of both recovered and remitted patients will be the same after cognitive behavior therapy (CBT) as after psychoanalytic psychotherapy (PPT).
2. At the end of each treatment (20 weeks after the start of CBT / 2 years after the start of PPT) the percentage of both recovered and remitted patients will be the same after CBT as after PPT.
3. Two years after the start of the treatment in an intent-to-treat analysis the per-centage of both recovered and remitted patients will be the same after CBT as after PPT
4. At follow-up 2½, 3½, and 5 years after the start of the treatment in an intent-to-treat analysis the percentage of both recovered and remitted patients will be the same after CBT as after PPT
Ethics approval(s)Research Ethics Committee, Capital Region of Denmark, 21/03/2004
Health condition(s) or problem(s) studiedBulimia Nervosa (DSM-IV-TR)
Intervention1. Psychoanalytic psychotherapy, weekly sessions for two years (approximately 90 sessions)
2. Cognitive behavior therapy, 21 sessions over approximately 20 weeks
Intervention typeOther
Primary outcome measure1. Recovery from bulimia nervosa, defined as no binge eating or purging during the previous 28 days assessed with the Eating Disorder Examination (Fairburn & Cooper, 1993)
2. Remission of the bulimic symptoms, defined as binge eating and purging less than twice per week over the last 28 days (i.e. below the DSM-IV frequency threshold) assessed with the Eating Disorder Examination (Fairburn & Cooper, 1993)
Secondary outcome measuresSymptom measures
1. Symptom Checklist-92 (SCL-92) (Derogatis, 1983; Derogatis & Lazarus, 1994)
2. Beck Depression Inventory (BDI) (Beck et al., 1961)
3. State-Trait Anxiety Inventory (STAI) (Spielberger, 1983)
4. Target complaints (TC) (Battle et al., 1966; Mintz & Kiesler, 1982)

Personality measures
1. Defense Style Questionnaire-40 (DSQ-40) (Bond et al., 1983)
2. Inventory of Interpersonal Problems (IIP) (Horowitz et al., 1988)
3. Inventory of Personality Organization (IPO) (Lenzenweger et al., 2001)
4. Adult Attachment Interview (AAI) (George et al., 1985; Main & Goldwyn, 1998)
5. Reflective-Functioning Scales (Fonagy et al., 1998)
Overall study start date08/11/2004
Completion date31/05/2013

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants70
Key inclusion criteria1. Age > 17 years
2. Patient fulfilling the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for bulimia nervosa
3. The patient has signed written informed consent before randomisation
Key exclusion criteria1. Concurrent ICD-10 diagnosis within the categories F00-31 (organic disorders, substance-related disorders, disorders of the schizophrenic spectrum, manic and bipolar disturbances), F32.1, 32.2, 32.3, 33.1, 33.2 and 33.3 (moderate and severe depression)
2. Concurrent ICD-10 diagnosis within the categories F40-49 (anxiety disorders, dissociative disorders, somatoform disorders), if the disorder is judged to be a major obstacle to the psychotherapeutic treatment of bulimia
3. Alcohol dependency or abuse of psychoactive substances
4. Concurrent somatic illness which will be a major obstacle to the psychothera-peutic treatment
5. Pregnancy or plans interfering with the treatment such as longer travels
6. Inability to speak and/or understand Danish
Date of first enrolment08/11/2004
Date of final enrolment31/05/2008

Locations

Countries of recruitment

  • Denmark

Study participating centre

University of Copenhagen
Copenhagen K
DK-1353
Denmark

Sponsor information

Danish Council for Independent Research (Denmark)
Government

Funders

Funder type

Government

Danish Council for Independent Research, Humanities (Denmark) ref: 9901684/25-01-0011

No information available

Egmont Foundation (Denmark) ref: 41470

No information available

Ivan Nielsen Foundation (Denmark) ref: 07018005

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan