Background: The aim of this study was to compare the immediate and longer-term effects of two cognitive behaviour therapy programmes for hospitalized patients with anorexia nervosa, one focused exclusively on the patients' eating disorder features and the other focused also on mood intolerance, clinical perfectionism, core low self-esteem or interpersonal difficulties. Both programmes were derived from enhanced cognitive behaviour therapy (CBT-E) for eating disorders. Methods: Eighty consecutive patients with severe anorexia nervosa were randomized to the two inpatient CBT-E programmes, both of which involved 20 weeks of treatment (13 weeks as an inpatient and 7 as a day patient). The patients were then followed up over 12 months. The assessments were made blind to treatment condition. Results: Eighty-one percent of the eligible patients accepted inpatient CBT-E, of whom 90% completed the 20 weeks of treatment. The patients in both programmes showed significant improvements in weight, eating disorder and general psychopathology. Deterioration after discharge did occur but it was not marked and it was restricted to the first 6 months. There were no statistically significant differences between the effects of the two programmes. Conclusions: These findings suggest that both versions of inpatient CBT-E are well accepted by these severely ill patients and might be a viable and promising treatment for severe anorexia nervosa. There appears to be no benefit from using the more complex form of the treatment.

Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change.Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based on the enhanced cognitive behavior therapy (CBT-E). The patients were assessed before and after hospitalization, and 6 and 12 months later.Results: Twenty-six patients (96%) completed the program. In these patients, there was a substantial improvement in weight, eating disorder features, and general psychopathology that was well maintained at 12-month follow-up.Conclusion: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa.

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Objective This study aimed to compare the effectiveness of an intensive treatment based on enhanced cognitive behavioral therapy (CBT‐E) in adolescent and adult patients with anorexia nervosa. Methods A total of 150 consecutive patients (74 adolescents and 81 adults) were admitted to a 20‐week intensive CBT‐E program (13 weeks of inpatient followed by 7 weeks of day‐hospital treatment). All patients had responded poorly to previous outpatient treatments and were assessed at admission, end of treatment (EOT), and 20‐ and 60‐week follow‐ups. Results About 70% of eligible patients began the program, and more than 85% completed it. Body mass index (BMI) in adults and BMI‐for‐age percentile in adolescents improved significantly from baseline to EOT, remained stable until 20‐week follow‐up, and slightly decreased from 20‐week follow‐up to 60‐week follow‐up, while remaining in the lower normal range. Eating disorder psychopathology, general psychopathology, and clinical impairment scores decreased significantly at EOT and showed only a slight increase from EOT to follow‐ups. No difference was found between adolescent and adult patients in treatment acceptance, dropout, or any outcome measure. Discussion These findings indicate that intensive CBT‐E seems to be an effective treatment for severely ill adolescent and adult patients with anorexia nervosa.

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