Table 15 Cognitive behavioural therapy for Anorexia Nervosa
From: Canadian practice guidelines for the treatment of children and adolescents with eating disorders
| Certainty assessment | Impact | Certainty | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
| Weight (assessed with: BMI), Psychological symptoms (EDE) | |||||||||
| 1 | randomised trials | not serious | not serious | not serious | not serious | none | RCT with 11 adolescents and young adults in CBT group compared to 11 in the Behavioural Family Therapy group (age range 13–23). There were no significant differences in terms of weight. | ⨁⨁⨁⨁ HIGH | CRITICAL |
| not serious | not serious | not serious | not serious | none | No differences seen in the eating psychopathology on the EDE between treatment groups. | ⨁⨁⨁⨁ HIGH | CRITICAL | ||
| Weight (assessed with: kg), psychological symptoms with EDE | |||||||||
| 1 | Case Series | very serious a,b | not serious | not serious | not serious | strong association | This was a large case series of 49 adolescents age 13 to 17 years, all female. 40 sessions weekly for 45 min. Weight was significantly increased by an average of 8.6 kg comparing pre to post weight. | ⨁◯◯◯ VERY LOW | CRITICAL |
| very serious a,b | not serious | not serious | not serious | strong association | EDE scores were substantially decreased by a score of 2.03 (range 0–6) indicating psychological symptoms were much improved from pre to post treatment. | ⨁◯◯◯ VERY LOW | CRITICAL | ||
| Weight (assessed with: kg), psychological symptoms | |||||||||
| 8 | Case Reports | very serious a,b | not serious | not serious | not serious | none | 8 case reports describing 8 adolescents (7 females, 1 male) with AN treated with CBT. One case had comorbid OCD. Weight improved with treatment. Age range 11.5 to 17 years. | ⨁◯◯◯ VERY LOW | CRITICAL |
| very serious a,b | not serious | not serious | not serious | none | Improved EDE scores and EDI scores as well as improved eating behaviours in terms of a reduction in restricted eating. | ⨁◯◯◯ VERY LOW | CRITICAL | ||