Table 3 Family-based treatment for bulimia 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 | |||
| Remission (assessed with: Abstinence from binge or purge behaviour for 4 weeks) Psychological Symptoms (assessed with: EDE), Depression (assessed with: BDI), | |||||||||
| 3 | randomised trials | not serious | serious a,b,c | not serious | not serious | none | one RCT (n = 130) compared FBT to CBT for adolescents with BN. FBT group achieved significantly higher remission rates (39% vs. 20%) at end of study. One RCT (n-85) compared FBT to CBT guided self care and found no difference in BP remission (although Binge alone was decreased in the CBT group). One RCT randomized 80 patients to FBT or supportive psychotherapy. 39% in FBT vs. 18% in supportive therapy were in remission at end of treatment; a significant difference. | ⨁⨁⨁◯ MODERATE | CRITICAL |
| not serious | serious a,b,c | not serious | not serious | none | one RCT (n = 130) did not find any differences in EDE score at end of treatment for FBT vs. CBT for adolescents with BN. The other RCT (n = 80) also showed all EDE scores were more improved in the FBT group compared to supportive group. | ⨁⨁⨁◯ MODERATE | CRITICAL | ||
| not serious | serious a,b,c | not serious | not serious | none | One RCT (n = 130) showed a decrease in depression scores that was greater in the FBT group compared to the CBT group at the end of the study. Another RCT (n = 80) did not show any differences in depression scores between FBT and supportive group. | ⨁⨁⨁◯ MODERATE | CRITICAL | ||
| Binge Purge Frequency (assessed with: Frequency Scores) | |||||||||
| 2 | Case Reports | very serious d,e | not serious | not serious | not serious | none | Two case reports of 9 patients in total describe decreases in binge and purge behaviours with FBT pre compared to post. | ⨁⨁⨁◯ VERY LOW | CRITICAL |