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Comparing the effectiveness and predictors of cognitive behavioural therapy-enhanced between patients with various eating disorder diagnoses: a naturalistic study

Published online by Cambridge University Press:  11 April 2022

Bernou Melisse Open the ORCID record for Bernou Melisse [Opens in a new window] ,
Jack Dekker ,
Elske van den Berg ,
Margo de Jonge ,
Eric F. van Furth ,
Jaap Peen  and
Edwin de Beurs
Bernou Melisse*
Affiliation:
Novarum Center for Eating Disorders & Obesity, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands
Jack Dekker
Affiliation:
Arkin Mental Health Institute, Research Department, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
Elske van den Berg
Affiliation:
Novarum Center for Eating Disorders & Obesity, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands
Margo de Jonge
Affiliation:
Novarum Center for Eating Disorders & Obesity, Laan van de Helende Meesters 2, 1186 AM Amstelveen, The Netherlands
Eric F. van Furth
Affiliation:
Rivierduinen Eating Disorders Ursula, Sandifortdreef 19, 2333 ZZ, Leiden, The Netherlands Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
Jaap Peen
Affiliation:
Arkin Mental Health Institute, Research Department, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands
Edwin de Beurs
Affiliation:
Arkin Mental Health Institute, Research Department, Klaprozenweg 111, 1033 NN Amsterdam, The Netherlands Leiden University, Section Clinical Psychology, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
*
*Corresponding author. Email: [email protected]
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Abstract

Cognitive behaviour therapy-enhanced (CBT-E) is an effective treatment for non-underweight patients with eating disorders. Its efficacy and effectiveness is investigated mostly among transdiagnostic samples and remains unknown for binge eating disorder. The aim of the present study was to assess several treatment outcome predictors and to compare effectiveness of CBT-E among adult out-patients with bulimia nervosa (n=370), binge eating disorder (n=113), and those with a restrictive food pattern diagnosed with other specified feeding and eating disorders (n=139). Effectiveness of CBT-E was assessed in routine clinical practice in a specialised eating disorders centre. Eating disorder pathology was measured with the EDEQ pre- and post-treatment, and at 20 weeks follow-up. Linear mixed model analyses with fixed effect were performed to compare treatment outcome among the eating disorder groups. Several predictors of treatment completion and outcome were examined with a regression analysis. No predictors for drop-out were found, except the diagnosis of bulimia nervosa. Eating disorder pathology decreased among all groups with effect sizes between 1.43 and 1.70 on the EDE-Q total score. There were no differences in remission rates between the three groups at end of treatment or at follow-up. Eating disorder severity at baseline affected treatment response. The results can be generalised to other specialised treatment centres. No subgroup of patients differentially benefited from CBT-E supporting the transdiagnostic perspective for the treatment of eating disorders. Longer-term follow-up data are necessary to measure persistence of treatment benefits.

Key learning aims

  1. (1) What is the effectiveness of CBT-E among patients suffering from binge eating disorder?

  2. (2) Does any subgroup of patients suffering from an eating disorder differentially benefit from CBT-E?

  3. (3) What factors predict treatment response?

Keywords

binge eating disorderbulimia nervosacognitive behaviour therapy-enhancedeating disordersother specified feeding and eating disorder
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e20
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Moore, E., Hinde, M., & Waller, G. (2021). Brief cognitive behavioural therapy for binge-eating disorder: clinical effectiveness in a routine clinical setting. The Cognitive Behaviour Therapist, 14. doi: https://doi.org/10.1017/S1754470X21000131 CrossRefGoogle Scholar
van den Berg, E., Melisse, B., Koenders, J., de Jonge, M., Blankers, M., de Beurs, E., & Dekker, J. (2020). Online cognitive behavioral therapy enhanced for binge eating disorder: study protocol for a randomized controlled trial. BMC Psychiatry, 20, 190. doi: 10.1186/s12888-020-02604-1 CrossRefGoogle ScholarPubMed
Waller, G., Tatham, M., Turner, H., Mountford, V. A., Bennetts, A., Bramwell, K., Dodd, J., Ingram, L. (2018). A 10-session cognitive-behavioral therapy (CBT-T) for eating disorders: outcomes from a case series of nonunderweight adult patients. International Journal of Eating Disorders, 51, 262–269. https://doi.org/10.1002/eat.22837 CrossRefGoogle ScholarPubMed

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