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Practice guidelines favor cognitive-behavioral therapy (CBT) for treating bulimia nervosa. However, many clinicians treat the condition with psychodynamically oriented psychotherapy, which has not been compared head to head with CBT. Investigators in Denmark randomly assigned 70 patients with bulimia nervosa (99% women) to either 21 sessions of CBT-enhanced (focusing on engagement, body image concerns, and coping skills)at varying intervals over 20 weeks, plus one session 20 weeks later, or to 2 years of weekly manual-guided psychoanalytic psychotherapy (PPT) for bulimia nervosa. Randomization was stratified by diagnosis of personality disorder (37%) and pharmacological treatment (14%). One author receives royalties for CBT-enhanced.
Therapi…