Universitetets Psykologiske Klinik Stig Poulsen & Susanne Lunn Stolpegård d. 31.oktober 2006

Universitetets Psykologiske Klinik Uddannelse af studerende Efteruddannelse af yngre psykologer (kandidater) Forskning i udvalgte problemstillinger (ex. psykoterapi for bulimi)

Basisbatteriet Instrumenter: N (præ) > 250 Vanskeligheder og problemer (~ Target Complaints) SCL-92 IIP-127 SNAP (frem til 2004) N (præ) > 250

Basisbatteriet Behandling: Studenterterapier (12 – 31 sessioner) Individuel psykoterapi af varierende varighed Længerevarende psykoanalytisk psykoterapi (2 g. ugtl. i 2 år) Gruppeanalytisk terapi (slow open)

The bulimi trial A comparison of the immediate and long-term outcome of two different individual psychotherapeutic treatments for bulimia nervosa, i.e. cognitive behaviour therapy (CBT) for 20 weeks and psychoanalytic psychotherapy (PPT) for two years

Treatments Individual psychoanalytic psychotherapy (PPT) once weekly for two years (appr. 90 sessions). Individual cognitive behaviour therapy (CBT) for 21 sessions (over appr. 20 weeks).

Design Duration of CBT: 6 months Duration of PPT: 24 months First 30 months: All pt. retested every 6 months Further follow-up after 42 months and after 60 months

Primary outcome variables Recovery from bulimia nervosa (no binge eating or purging during the previous 28 days) Remission of the bulimic symptoms, (binge eating and purging less than twice per week over the last 28 days)

Inclusion criteria Age:  18 years Patient fulfilling the DSM-IV criteria for bulimia nervosa Informed consent before randomisation

Exclusion criteria organic disorders substance-related disorders disorders of the schizophrenic spectrum manic and bipolar disturbances moderate and severe depression dissociative disorders anxiety and somatoform disorders if major obstacle to the psychotherapeutic treatment of bulimia

Exclusion criteria (cont.) Pregnancy or plans interfering with the treatment such as longer travels Inability to speak or understand Danish

Diagnostic and personality assessment Eating Disorder Examination (EDE) (Fairburn & Cooper, 1993) Present State Examination, Short Version for Clinical Use (PSE) (Bertelsen, 1995) Structured Clinical Interview for DSM-III-R (SCID-II) (Spitzer et al., 1990) Karolinska Psychodynamic Profile (KAPP) (Weinryb & Rössel, 1991) Adult Attachment Interview (AAI) (George et al., 1985; Main & Goldwyn, 1998)

Outcome measures (symptoms) EDE Symptom Checklist-92 (SCL-92) (Derogatis, 1983) Beck Depression Inventory (BDI) (Beck et al., 1961) State-Trait Anxiety Inventory (STAI) (Spielberger, 1983) Target Complaints (TC) (Battle et al., 1966)

Outcome measures (personality) SCID-II (First et al., 1997) Defense Style Questionnaire-40 (DSQ-40) (Bond et al., 1983) Inventory of Interpersonal Problems (IIP) (Horowitz et al., 1988) Inventory of Personality Organization (IPO) (Lenzenweger et al., 2001) AAI Reflective-Functioning Scales (Fonagy et al., 1998)