Abstract
The number of patients with bulimia nervosa who consult a doctor on their own initiative is larger than that of patients with anorexia nervosa who consult a doctor by themselves. The number of patients suffering from bulimia nervosa and giving up their treatment by themselves is, however, also larger than that of patients suffering from anorexia nervosa who give up treatment arbitrarily. The treatment processes of patients with bulimia nervosa are liable to be prolonged and, what is worse, there would be many complications. Therefore, having the continuity of treatment, periodical clinical examinations, and constant strokes facilitating behavioral changes by guidance for patients' Iife and/or psychotherapeutic approach are the most important factors for the care of bulimia nervosa patients. Recently, pharmacotherapy with SSRI has been noticed as a treatment for bulimia nervosa. Thus, we have investigated the effect of the early administration of SSRI to bulimia nervosa patients on the continuation of treatment. A total of 19 patients of the Psychosomatic Department of Toho University Hospital who had beed daiagnosed as bulimia nervosa by DSM-IV, and had agreed to take SSRI clinical trial at the same time, participated in this study. The result was that 8 cases (42%) discontinued their treatment during the SSRI clinical trial, and 1 case (5%) discontinued right after the trial, while 10 cases (53%) continued to be treated after the trial. This result show that treatment continuity with use of SSRI is better than that of pharmacotherapy groups with other drugs, and inferior to that of hospitalization. Thereby, it is suggested that, treatment with SSRI could be helpful to increase the continuity of treatment which is essential to facilitate behavioral changes by guidance of patients' Iife and/or psychotherapeutical approaches. It should be emphasized, however, that the effect of written consent is indispensable effect of written consent should not be ignored.
