Table 1.

Interventions for Anorexia Nervosa.

Author	N (% female)	Recruitment source	Diagnostic/inclusion criteria	Exclusion criteria	Tx conditions (duration and setting)	Primary outcome assessed	Secondary outcome assessed	Primary results	Secondary results
Psychopharmacological Interventions
Antidepressants
Fluoxetine
Kaye et al.12	39 (100)	Inpatient ED Program responders	DSM-IV ANr		52 weeks Outpatient 20 mg – FLX – PL	Weight change for relapse prevention, YBOCS-EDS	HRSD, YBOCS, HARS	FLX had significant change in weight, Y-BOCS-ED from pre-post tx, PL did not greater tx completion for FLX vs. PL (63% vs. 16%)	FLX had significant change in HARS, HRSD from pre-post tx, PL did not
Walsh et al.15	93 (100)	Weight restored patients with AN	DSM-IV AN (w/o amenorrhea), 16–45 years old, BMI > 19		52 weeks Outpatient 20–80 mg – FLX + CBT – PL + CBT	Time to relapse		FLX = PL
Antipsychotics
Olanzapine
Mondraty et al.20	15 (–)	Inpatient psychiatric unit	DSM-IV AN		Inpatient – 46 ± 31 days OLZ (10 mg) – 53 ± 31 days CPZ (20 mg)	Anorectic rumination (Padua inventory), weight		OLZ > CPZ
Brambilla et al.18	30 (100)	ED center referrals	DSM-IV AN >18 years old	Serious psychiatric or medical condition	3 months Outpatient – CBT + OLZ (2.5–5 mg) – CBT + PL	BMI, EDI, YBC-EDS	HRSD, TCI, Buss-Durkee rating scale (aggression)	OLZ > PL on YBC-ED compulsions, on BMI for ANbp only	OLZ > PL on HRSD, TCI-persistence
Bissada et al.17	34 (100)	ED tx center referrals	DSM-IV AN (w/o amenorrhea), BMI < 17.5	Serious psychiatric or medical condition, suicidality, concurrent tx	10 weeks Day hospital – OLZ (2.5–10 mg) – PL	BMI	PAI, YBOCS	OLZ > PL	OLZ > PL on YBOCS obsessions
Attia et al.19	23 (96)	Community recruitment	DSM-IV AN w/o amenorrhea, >16 years old, 19 > BMI >14	Severe medical or psychiatric problem	8 weeks Outpatient – OLZ (mean:7.95 mg) – PL (mean:8.75 mg)	BMI, EDI, YCB-EDS, BSQ	BAI, BDI	OLZ > PL on BMI	OLZ = PL
Psychosocial Interventions
Psychodynamic
Dare et al.26	84 (74)	Community referrals	DSM-IV AN, > 18 years old	Serious psychiatric or medical condition	1 year Outpatient – FOC – CAT – FT – TAU	M-R scales, weight		FOC, FT > TAU CAT = TAU on weight
Cognitive Behavioral Therapy
Pike et al.30	33 (100)	Inpatient tx responders	DSM-IV ANr, 18–45 years old, >90% IBW	Severe comorbid psychopathology	50 sessions Outpatient – CBT – NUT	Relapse rate, time to relapse, M-R scales		CBT > NUT
McIntosh et al.33	56 (100)	Community referrals	DSM-IV AN, 17–40 years old, BMI < 19	Severe psychiatric or medical condition	20 sessions Outpatient – CBT – IPT – NST	Global anorexia nervosa rating, BMI, weight, EDE, EDI	GAF	CBT = IPT CBT = NST On global rating CBT = NST > IPT on EDE restraint	NST > IPT = CBT
Interpersonal Psychotherapy
McIntosh et al.33	56 (100)	Community referrals	DSM-IV AN, 17–40 years old, BMI < 19	Severe psychiatric or medical condition	20 sessions Outpatient – CBT – IPT – NST	Global anorexia nervosa rating, BMI, weight, EDE, EDI	GAF	CBT = IPT NST > IPT On global rating CBT = NST > IPT on EDE restraint	NST > IPT = CBT
Family Based Therapy
Eisler et al.40	40 (98)	Community referrals	DSM-IV or ICD-10 AN		Mean of 16 sessions (flexible dose) Outpatient – CFT – SFT	M-R scales, EDI, EAT	RSES, SMFQ, MOCI	SFT > CFT for families with high EE CFT > SFT on EDI	CFT > SFT on MOCI, SMFQ
Geist et al.131	61 (100)	Community referrals to specialist tx center	DSM-IV AN < 90% IBW, 12–17 years old	Suicide risk, serious psychiatric or medical condition	8 sessions Outpatient – FT – FGP	Weight, EDI	CDI, BSI, FAM-III	FT = FGP	FT = FGP
Dare et al.26	84 (74)	Community referrals	DSM-IV AN, > 18 years old	Serious psychiatric or medical condition	1 year Outpatient – FOC – CAT – FT – TAU	M-R scales, weight		FOC, FT > TAU on weight
Lock et al.39	86 (90)	Pediatric referrals	DSM-IV AN (≥1 menstrual cycle missed), 12–18 years old	Serious psychiatric or medical condition, additional tx	Outpatient – STFT (10 sessions) – LTFT (20 sessions)	EDE, BMI, YBC-EDS	KSADS, CBCL, family functioning scale	STFT = LFT	STFT = LFT
Lock et al.37	121 (91)	Community clinic referrals	DSM-IV AN w/o amenorrhea, 12–18 years old, living with family, IBW < 86%	Serious psychiatric or medical condition, previous FT, AFT tx	24 sessions Outpatient – FT – AFT 6 and 12 month follow-up	Remission rate, BMI percentile		FT = AFT on remission rate FT > AFT on BMI At follow-up: FT > AFT on remission rate FT = AFT on BMI
Psychopharmacological + Psychosocial Interventions
Walsh et al.15	93 (100)	Weight restored patients with AN	DSM-IV AN (w/o amenorrhea) 16–45 years old, BMI > 19		52 weeks Outpatient 20–80 mg – FLX + CBT – PL + CBT	Time to relapse		FLX + CBT = PL + CBT
Brambilla et al.18	30 (100)	ED center referrals	DSM-IV AN >18 years old	Serious psychiatric or medical condition	3 months Outpatient – CBT + OLZ (2.5–5 mg) – CBT + PL	BMI, EDI, YBC-EDS	HRSD, TCI, Buss-Durkee rating scale (aggression)	CBT + OLZ > CBT + PL on eating disorder compulsions, on BMI for ANbp only	CBT + OLZ > CBT+ PL HRSD, TCI-persistence

Note: Greater than symbol (>) refers to significantly better outcome.

Abbreviations: AFT, Adolescent Focused Therapy; AN, Anorexia Nervosa; BDI, Beck Depression Inventory; BED, Binge Eating Disorder; BMI, Body Mass Index; BN, Bulimia Nervosa; BSI, Brief Symptom Inventory; CBCL, Child Behavior Checklist; CBT, Cognitive Behavioral Therapy; CDI, Children’s Depression Inventory; CFT, Conjoint Family Therapy; CGI, Clinical Global Impression; EAT, Eating Attitudes Test; ED, Eating Disorder; EDI, Eating Disorders Inventory; EDE, Eating Disorders Examination; FAM-II, Family Assessment Measure; FGP, Family Group Psychoeducation; FLX, Fluoxetine; FLV, Fluvoxamine; FT, Family-Based Therapy; FOC, Focal therapy; g, Group Therapy; GAF, Global Assessment of Functioning; HRSD, Hamilton Rating Scale for Depression; IPT, Interpersonal Psychotherapy; K-SADS, Kiddie Schedule of Affective Disorders; LTFT, Long Term Family Therapy; MOCI, Maudsley Obsessive Compulsive Index; M-R, Morgan-Russell Outcome; NST, Nonspecific Supportive Therapy; NUT, Nutritional Counseling; PAI, Personality Assessment Inventory; PL, Placebo; RSES, Rosenberg Self Esteem Scale; SFT, Separated Family Therapy; SMFQ, Short Mood and Feelings Questionnaire; STFT, Short Term Family Therapy; TFEQ, Three Factor Eating Questionnaire; TOP, Topiramate; WL, Wait List Control; YCB-EDS, Yale Cornell Brown ED Scale.