{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:34:47Z","timestamp":1791027287935,"version":"4.1.0"},"reference-count":60,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2002,8,23]],"date-time":"2002-08-23T00:00:00Z","timestamp":1030060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Since the description of bulimia nervosa as a distinct diagnostic entity in 1979, several psychological and pharmacological interventions have been developed and empirically tested. The existence of several effective treatments, none of which is completely effective, is common to most psychiatric conditions. The research question that flows from such findings is whether second\u2010level treatments would be effective for those who fail initial treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In the case of bulimia nervosa, the research findings suggest that cognitive behavioral therapy (CBT) is the first level of treatment and that both antidepressant medication and interpersonal psychotherapy (IPT) may potentially be effective second\u2010level treatments. This was a multicenter study in which 194 patients were initially treated with CBT. Those treated unsuccessfully (<jats:italic>n<\/jats:italic> = 62) were then randomized to treatment with IPT or medication management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of those assigned to secondary treatment, 37 completed such treatment and 25 dropped out or were withdrawn. The abstinence rate for subjects assigned to treatment with IPT was 16% and for those assigned to medication management was 10%. No significant differences were found between medication and IPT in either the intent\u2010to\u2010treat or completer analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Dropout rates were high, and response rates were low among BN patients assigned to secondary treatments who failed to achieve remission with CBT. Offering lengthy sequential treatments appears to have little value, and alternative models for therapy need to be tested. \u00a9 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 271\u2013281, 2002.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.10092","type":"journal-article","created":{"date-parts":[[2002,9,5]],"date-time":"2002-09-05T20:29:04Z","timestamp":1031257744000},"page":"271-281","source":"Crossref","is-referenced-by-count":71,"title":["A randomized secondary treatment study of women with bulimia nervosa who fail to respond to CBT"],"prefix":"10.1002","volume":"32","author":[{"given":"James E.","family":"Mitchell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Halmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Terence","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Stewart","family":"Agras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Kraemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Crow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,8,23]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1176\/appi.ajp.157.8.1302","article-title":"Outcome predictors for the cognitive\u2010behavioral treatment of bulimia nervosa: Data from a multisite study","volume":"157","author":"Agras W.S.","year":"2000","journal-title":"American Journal of Psychiatry"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198701)6:1<29::AID-EAT2260060105>3.0.CO;2-2"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.149.1.82"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.57.2.215"},{"key":"e_1_2_1_6_1","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1093\/ajcn\/53.4.865","article-title":"Effect of a tricyclic antidepressant and opiate antagonist on binge eating behavior in normal weight bulimic and obese, binge eating subjects","volume":"53","author":"Alger A.","year":"1991","journal-title":"American Journal of Clinical Nutrition"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674378803300211"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198808000-00005"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.141.12.1512"},{"key":"e_1_2_1_11_1","volume-title":"New applications of interpersonal psychotherapy","author":"Fairburn C.G.","year":"1993"},{"key":"e_1_2_1_12_1","volume-title":"Binge eating: Nature, assessment, and treatment","author":"Fairburn C.G.","year":"1993"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1991.01810290075014"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(86)90058-6"},{"key":"e_1_2_1_15_1","volume-title":"Binge Eating: Nature, Assessment, and Treatment","author":"Fairburn C.G.","year":"1993"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950160054010"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1997.tb09636.x"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-199602000-00003"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1014424"},{"key":"e_1_2_1_20_1","volume-title":"Structured clinical Interview for DSM\u2010IV Personality Disorders (SCID\u2010II, Version 2.0)","author":"First M.B.","year":"1994"},{"key":"e_1_2_1_21_1","volume-title":"Structured clinical interview for DSM\u2010IV Axis I Disorders. Patient Edition (SCID\u2010I\/P. Version 2.0)","author":"First M.B.","year":"1995"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820020059008"},{"key":"e_1_2_1_23_1","unstructured":"Franko D.L. Zuroff D.C. &Rosenthal F.(1986).Construct validation of the Bulimic Thoughts Questionnaire. Paper presented at the Society of Behavioral Medicine San Francisco CA."},{"issue":"3","key":"e_1_2_1_24_1","first-page":"171","article-title":"Fluoxetine as a treatment for bulimia nervosa","volume":"11","author":"Freeman C.P.","year":"1987","journal-title":"International Journal of Obesity"},{"key":"e_1_2_1_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.296.6621.521"},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.1.37"},{"key":"e_1_2_1_27_1","doi-asserted-by":"crossref","unstructured":"Goldbloom D. Olmsted M. &Davis R.(1996).A randomized controlled trial of fluoxetine and individual cognitive behavioral therapy for women with bulimia nervosa: Short\u2010term outcome. Paper presented at the American Psychiatric Association meeting New York NY.","DOI":"10.1016\/S0005-7967(97)00041-7"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.166.5.660"},{"key":"e_1_2_1_29_1","first-page":"262","article-title":"Treatment of bulimia with bupropion: A multi\u2010center controlled trial","volume":"49","author":"Horne R.L.","year":"1988","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_2_1_30_1","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1037\/0022-006X.56.6.885","article-title":"Inventory of interpersonal Problems: Psychometric properties and clinical applications","volume":"56","author":"Horowitz L.M.","year":"1998","journal-title":"Journal of Consulting and Clinical Psychology"},{"key":"e_1_2_1_31_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1001\/archpsyc.1986.01800020092012","article-title":"Treating bulimia with desipramine: A double\u2010blind, placebo\u2010controlled study","volume":"43","author":"Hughes P.L.","journal-title":"Archives of General Psychiatry"},{"key":"e_1_2_1_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198812000-00002"},{"key":"e_1_2_1_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198510000-00005"},{"key":"e_1_2_1_34_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.53.1.43"},{"key":"e_1_2_1_35_1","volume-title":"Interpersonal therapy of depression","author":"Klerman G.L.","year":"1984"},{"key":"e_1_2_1_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.286.6378.1609"},{"key":"e_1_2_1_37_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.159.2.250"},{"key":"e_1_2_1_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198605)5:4<599::AID-EAT2260050402>3.0.CO;2-W"},{"key":"e_1_2_1_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.4.535"},{"key":"e_1_2_1_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(94)90082-5"},{"key":"e_1_2_1_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198408000-00003"},{"key":"e_1_2_1_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199311)14:3<277::AID-EAT2260140306>3.0.CO;2-8"},{"key":"e_1_2_1_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1098-108X(199611)20:3<219::AID-EAT1>3.0.CO;2-R"},{"key":"e_1_2_1_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1990.01810140049008"},{"key":"e_1_2_1_45_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.53.3.305"},{"key":"e_1_2_1_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00432258"},{"key":"e_1_2_1_47_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.140.5.554"},{"key":"e_1_2_1_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004714-198908000-00004"},{"key":"e_1_2_1_49_1","volume-title":"Conceiving the self","author":"Rosenberg M.","year":"1979"},{"key":"e_1_2_1_50_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700031974"},{"key":"e_1_2_1_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1983.tb05866.x"},{"key":"e_1_2_1_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(85)90010-8"},{"key":"e_1_2_1_53_1","unstructured":"Tellegen A.(1985).Brief manual for the Multidimensional Personality Questionnaire. Unpublished manuscript."},{"key":"e_1_2_1_54_1","first-page":"523","article-title":"Medication and psychotherapy in the treatment of bulimia nervosa","volume":"54","author":"Walsh B.T.","year":"1997","journal-title":"American Journal of Psychiatry"},{"key":"e_1_2_1_55_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1988.01800290091011"},{"key":"e_1_2_1_56_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1976.01770090101010"},{"key":"e_1_2_1_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(91)90007-P"},{"key":"e_1_2_1_58_1","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0005-7967(86)90187-7","article-title":"Cognitive behavioral treatment of bulimia nervosa: A controlled evaluation","volume":"24","author":"Wilson G.T.","year":"1986","journal-title":"Behavior and Research Therapy"},{"key":"e_1_2_1_59_1","unstructured":"Wilson T.(1999).A multisite comparison of CBT and IPT in the treatment of BN. Paper presented at the Eating Disorders Research Society Annual Meeting San Diego CA."},{"key":"e_1_2_1_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198601)5:1<21::AID-EAT2260050103>3.0.CO;2-P"},{"key":"e_1_2_1_61_1","first-page":"513","article-title":"Bulimia nervosa: A descriptive and therapeutic study","volume":"22","author":"Yates A.J.","year":"1986","journal-title":"Behavior and Research Therapy"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Feat.10092","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.10092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T11:11:35Z","timestamp":1700305895000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.10092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,8,23]]},"references-count":60,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2002,11]]}},"alternative-id":["10.1002\/eat.10092"],"URL":"https:\/\/doi.org\/10.1002\/eat.10092","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,8,23]]}}}