Psychological treatments, mainly cognitive behavior therapy (CBT), and the use of antidepressant medications are the modalities of treatment that have received the most empirical support in controlled studies. The results of two systematic reviews show that CBT is better then waiting list control and antidepressants are superior to placebo for the short term remission in bulimic symptoms. Direct comparisons of both treatments show that single CBT is clinically more effective and better accepted than single antidepressants. The combination of CBT with antidepressants is clinically more effective than each single approach, but acceptability of single psychological treatments is better. As BN is a serious mental disorder and spontaneous remission rates are low, the combined treatment, including a multidimensional and multidisciplinary approach, may be indicated.
Bulimia Nervosa; psychotherapy; antidepressants; cognitive-behavior therapy; systematic review; metanalysis; Treatment
