Abstract
BackgroundLittle research has investigated the use of evidence-based guidelines by eating disorder (ED) therapists, or prescribing of psychotropic medication. Moreover, people with EDs have rarely been surveyed on these topics, and their clinical and demographic features have not been presented. This study investigated perception of psychotherapy, psychotropic medication and the clinical characteristics of a community sample of people with EDs.MethodAn online survey methodology was used to recruit 253 people with eating disorders in the community. Where feasible, comparisons were made between four types of eating disorder, anorexia nervosa, bulimia nervosa, and two types of atypical or ‘sub-threshold’ eating disorder.ResultsUnlike medication, reported psychotherapy showed some congruence with evidence based and other guidance. Most participants were currently receiving either psychotherapy, medication or both, and most had a severe and chronic ED.ConclusionsFindings are considered in light of use of evidence-based treatment for EDs, calls for greater dissemination of cognitive behaviour therapy (CBT); indications that much may be poor quality; and the importance of what treatments to offer those who are chronically and severely ill. Development of theory and novel treatments is considered a priority.
Highlights
Little research has investigated the use of evidence-based guidelines by eating disorder (ED) therapists, or prescribing of psychotropic medication
Unlike medication, reported psychotherapy showed some congruence with evidence based and other guidance
Findings are considered in light of use of evidence-based treatment for EDs, calls for greater dissemination of cognitive behaviour therapy (CBT); indications that much may be poor quality; and the importance of what treatments to offer those who are chronically and severely ill
Summary
It is easy to criticise non-evidence based psychotherapy, and the apparently widespread use of psychotropic medication that lacks an evidence base for EDs. As their scores and history indicate, this sample is seriously and chronically ill It is not easy for therapists and services to do nothing. If CBT has failed ( well delivered), it is hard to justify providing it again, and perhaps understandably, patients and therapists may seek alternative psychotherapies. It is not clear why fluoxetine is given or taken so rarely (some suggestions are given above). MJC helped design the study, conducted some of the data analysis, reviewed the literature and prepared the manuscript. Both authors read and approved the final manuscript. Authors’ information The data were collected in part fulfilment of HK’s doctorate in clinical psychology at the University of Oxford
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