Specific self-esteem and social skills group therapy in patients with eating disorders can be useful in improving certain core features.

Anxiety, binging, purging, and psychopathological scales improve with a CE program in resistant bulimia nervosa.

Several studies have related motivation to change and treatment response in adult patients with bulimia nervosa but there are no longitudinal studies analysing this relationship in adolescents. The objective was to determine whether motivation to change is related to clinical improvement after treatment in adolescent patients with bulimia nervosa. The Bulimia Nervosa Stages of Change Questionnaire, the Eating Disorders Inventory (EDI-2) and the Beck Depression Inventory (BDI) were administered at the beginning of treatment to 40 adolescent patients with bulimia nervosa (DSM-IV) (mean age = 16.2 years). Thirty-one patients were re-assessed after 6 months of treatment. The majority of clinical and psychological variables improved significantly at the second evaluation. There were significant correlations between initial motivation to change and improvement in number of binges and the EDI-2 scales of Bulimia and Interoceptive Awareness. In the stepwise multiple linear regression analysis, which included initial motivation to change and other potential confounding variables such as age, BDI, duration of disorder and body mass index, only motivation to change was selected as a predictor of improvement in number of binges (standardized β coefficient = 0.45; p = 0.012) and of decrease on the Bulimia scale (standardized β coefficient = 0.43; p = 0.029). Regarding improvement in Interoceptive Awareness, only the BDI score was selected as an independent predictor (β coefficient = 0.58; p = 0.002). In conclusion, in adolescent patients receiving treatment for bulimia nervosa, improvement in bulimic symptomatology seems to be especially related to initial motivation to change.

ObjectiveThis study is a pragmatic randomized controlled trial, which compares the effectiveness of an adapted form of Dialectical Behavior Therapy for Adolescents (DBT‐A) and treatment as usual plus group sessions (TAU + GS) to reduce suicidal risk for adolescents in a community health mental clinic.MethodThirty‐five adolescents from a community outpatient clinic, with repetitive NSSI alone or with SA over the last 12 months and with current high suicide risk as assessed by the Columbia‐Suicide Severity Rating Scale (C‐SSRS), were enrolled. Participants were randomly assigned to undergo either DBT‐A (n = 18) or TAU + GT (n = 17) treatments over a 16‐week period. Primary outcomes were the difference between NSSI and SA recorded during the first 4 weeks and the final 4 weeks of treatment. Secondary outcomes included changes in Children’s Global Assessment Scale (C‐GAS), Suicidal Ideation Questionnaire (SIQ‐JR), and Beck Depression Inventory‐II (BDI‐II).ResultsDialectical Behavior Therapy for Adolescents was more effective than TAU + GS at reducing NSSI, use of antipsychotics, and improving C‐GAS. No SAs were reported in the two groups at the end of the treatment. Both treatments were equally effective in decreasing SIQ‐JR and BDI‐II scores.ConclusionsThese findings support the feasibility and effectiveness of DBT‐A for adolescents at high risk of suicide in community settings.

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