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Roz Shafran, Department of Psychiatry Oxford University Warneford Hospital Oxford UK,
Pamela K. Keel, Department of Psychology University of Iowa Iowa City, IA USA,
Alissa Haedt, Department of Psychology University of Iowa Iowa City, IA USA,
Christopher Fairburn, Department of Psychiatry Oxford University Warneford Hospital Oxford UK
Peter Tyrer, Imperial College of Science, Technology and Medicine, London,Kenneth R. Silk, University of Michigan, Ann Arbor
Psychological treatments are now the cornerstone of treatment for eating disorders, with cognitive behaviour therapy having pride of place. This chapter, in conjunction with Chapter 23, shows the importance of setting as a likely determinant of effective treatment, and the relatively limited knowledge we have on the subject. The chapter also illustrates a common problem when the preferred treatment is found to be ineffective; there is often no evidence base for any alternative strategy. The chapter is also a useful reminder not to be too rigid in linking diagnosis to treatment in eating disorders. The frequent changing from one eating diagnosis to another, and the common presentation of EDNOS (eating diorders not otherwise specified) shows the relative lack of utility of the current descriptions when it comes to selecting treatment.
It is the task of this chapter to evaluate the evidence on the psychological treatment of eating disorders. The strength of the evidence base for the treatment of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and remaining eating disorders not otherwise specified (EDNOS; or atypical eating disorders (AEDs)) varies, so each eating disorder will be considered separately. Examination of the evidence base requires the identification and appraisal of the relevant research findings. This has already been done in the UK by the National Institute for Health and Clinical Excellence (NICE) (National Collaborating Centre for Mental Health, 2004), which is the primary source of information on which this chapter is based.
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