Patient perspective of outpatient cognitive behavior therapy in anorexia nervosa - the ANTOP study

Background: There is still a scarcity of larger randomized controlled intervention studies in Anorexia nervosa (AN) and an evidence-based treatment of choice for this condition is missing. Examining the views of patients can therefore make a substantial contribution to the available evidence and help to develop further effective therapy approaches. The ANTOP study (Anorexia Nervosa Treatment of OutPatients) represents the largest multisite outpatient intervention trial on adults with AN. Its purpose was to examine the efficacy of two specific psychotherapeutic outpatient treatments for patients with AN, based on either enhanced cognitive behavior therapy (CBT-E) or focal psychodynamic therapy (FPT), in comparison to an optimized treatment as usual (TAU-O). Feedback of patients who had received CBT-E was analyzed in order to get information on acceptance and perceived quality of the therapy manual. Method: Eighty patients were treated with CBT-E. Sixty-one of the 72 CBT-E patients who had received at least 50 % of the overall 40 sessions (84,7 %) completed a feedback questionnaire at the end of the treatment. The questionnaire was specifically designed for the study and consisted of 11 open questions. At 1-year follow-up, the questionnaire was given again. Fifty-seven CBT-E patients (79,2 %) completed it then. Results: At the end of treatment, the majority of patients judged their therapy was personally successful. Besides eating disorder-specific aspects patients thought relationships to be a particularly relevant issue. At both times of assessment, manualized CBT-E was perceived as helpful by patients and length of therapy as appropriate. Conclusion: Besides assessing outcome parameters reflecting the pathology of AN, it is of great importance to investigate the views of patients on treatment. Their feedback can lead to a better understanding of the interactions between patient, therapist and therapy and help to improve available treatment options.