Archives of general psychiatry · 2010
Psychological treatments of binge eating disorder.
Сравнительное исследованиеСтатьяРандомизированное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Wilson G Terence, Wilfley Denise E, Agras W Stewart, Bryson Susan W
Аннотация
CONTEXT: Interpersonal psychotherapy (IPT) is an effective specialty treatment for binge eating disorder (BED). Behavioral weight loss treatment (BWL) and guided self-help based on cognitive behavior therapy (CBTgsh) have both resulted in short-term reductions in binge eating in obese patients with BED.
OBJECTIVE: To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.
DESIGN: Randomized, active control efficacy trial.
SETTING: University outpatient clinics.
PARTICIPANTS: Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED. Intervention Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.
MAIN OUTCOME MEASURES: Binge eating assessed by the Eating Disorder Examination.
RESULTS: At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.
CONCLUSIONS: Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00060762.
OBJECTIVE: To test whether patients with BED require specialty therapy beyond BWL and whether IPT is more effective than either BWL or CBTgsh in patients with a high negative affect during a 2-year follow-up.
DESIGN: Randomized, active control efficacy trial.
SETTING: University outpatient clinics.
PARTICIPANTS: Two hundred five women and men with a body mass index between 27 and 45 who met DSM-IV criteria for BED. Intervention Twenty sessions of IPT or BWL or 10 sessions of CBTgsh during 6 months.
MAIN OUTCOME MEASURES: Binge eating assessed by the Eating Disorder Examination.
RESULTS: At 2-year follow-up, both IPT and CBTgsh resulted in greater remission from binge eating than BWL (P < .05; odds ratios: BWL vs CBTgsh, 2.3; BWL vs IPT, 2.6; and CBTgsh vs IPT, 1.2). Self-esteem (P < .05) and global Eating Disorder Examination (P < .05) scores were moderators of treatment outcome. The odds ratios for low and high global Eating Disorder Examination scores were 2.8 for BWL, 2.9 for CBTgsh, and 0.73 for IPT; for self-esteem, they were 2.4 for BWL, 1.9 for CBTgsh, and 0.9 for IPT.
CONCLUSIONS: Interpersonal psychotherapy and CBTgsh are significantly more effective than BWL in eliminating binge eating after 2 years. Guided self-help based on cognitive behavior therapy is a first-line treatment option for most patients with BED, with IPT (or full cognitive behavior therapy) used for patients with low self-esteem and high eating disorder psychopathology.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00060762.
Предметные рубрики MeSH
AdultBehavior TherapyBinge-Eating DisorderBody Mass IndexCognitive Behavioral TherapyDiagnostic and Statistical Manual of Mental DisordersFemaleFollow-Up StudiesHumansInterpersonal RelationsLongitudinal StudiesMaleMiddle AgedObesityPsychiatric Status Rating ScalesPsychotherapySelf ConceptSelf-Help GroupsTreatment OutcomeWeight Loss