Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder
Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder
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DOI：
10.1038/oby.2005.126
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发表时间：
2005-06-01
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影响因子：
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通讯作者：
Walsh, BT
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文献类型：
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作者：
Devlin, MJ;Goldfein, JA;Walsh, BT
DEVLIN、MICHAEL J.、JULI A.GOLDFEIN、EVA PETKOVA、HUIPING JIANG、PAMELA S. RAIZMAN、SARA WOLK、LAUREL MAYER、JANEL CARINO、DARA BELLACE、CLAUDIA KAMENETZ、ILYSE DOBROW 和 B. TIMOTHY WALSH。认知行为疗法和氟西汀作为暴食症团体行为疗法的辅助疗法。奥贝斯水库。 2005年； 13:1077-1088. 目的：虽然暴食症是肥胖的常见且令人痛苦的伴随症状，但尚未确定接受行为体重控制计划的受影响个体是否应该接受专门治疗来补充标准治疗。本研究旨在检验在团体行为体重控制治疗背景下提供的个体认知行为疗法 (CBT) 和氟西汀这两种辅助干预措施的额外益处。 研究方法和程序：116 名患有暴食症的超重/肥胖女性和男性均被分配接受为期 20 周、为期 16 个疗程的团体行为体重控制治疗。同时，受试者在二乘二析因设计中被随机分配接受 CBT + 氟西汀、CBT + 安慰剂、氟西汀或安慰剂。在 16 个疗程的急性治疗阶段结束时评估的结果指标包括暴食频率、体重以及饮食相关和一般精神病理学指标。结果：总体而言，受试者在暴食以及一般和饮食相关精神病理学方面均表现出显着改善，但体重几乎没有减轻。接受单独 CBT 的受试者比未接受 CBT 的受试者暴食频率改善更多 (p < 0.001)，并且接受 CBT 的受试者与未接受 CBT 的受试者相比，暴食戒断率明显更高 (62% vs. 33%，p < 0.001)。氟西汀治疗与抑郁症状的更大程度减轻相关（p < 0.05）。 54 名实现暴饮暴食的受试者在所有指标上的进步都比 62 名未实现暴饮暴食的受试者要好。特别是，这些受试者平均减重 6.2 公斤，而非禁食者则增加 0.7 公斤。讨论：辅助性个人 CBT 可以显着减少接受标准行为体重控制治疗的肥胖暴食者的暴食率。
DEVLIN, MICHAEL J., JULI A. GOLDFEIN, EVA PETKOVA, HUIPING JIANG, PAMELA S. RAIZMAN, SARA WOLK, LAUREL MAYER, JANEL CARINO, DARA BELLACE, CLAUDIA KAMENETZ, ILYSE DOBROW, AND B. TIMOTHY WALSH. Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obes Res. 2005; 13:1077-1088.Objective: Although binge eating disorder is a common and distressing concomitant of obesity, it has not yet been established whether affected individuals presenting to behavioral weight control programs should receive specialized treatments to supplement standard treatment. This study was designed to examine the added benefit of two adjunctive interventions, individual cognitive behavioral therapy (CBT) and fluoxetine, offered in the context of group behavioral weight control treatment.Research Methods and Procedures: One hundred sixteen overweight/obese women and men with binge eating disorder were all assigned to receive a 16-session group behavioral weight control treatment over 20 weeks. Simultaneously, subjects were randomly assigned to receive CBT + fluoxetine, CBT + placebo, fluoxetine, or placebo in a two-by-two factorial design. Outcome measures, assessed at the end of the 16-session acute treatment phase, included binge frequency, weight, and measures of eating-related and general psychopathology.Results: Overall, subjects showed substantial improvement in binge eating and both general and eating-related psychopathology, but little weight loss. Subjects who received individual CBT improved more in binge frequency than did those not receiving CBT (p < 0.001), and binge abstinence was significantly more common in subjects receiving CBT vs. those who did not (62% vs. 33%, p < 0.001). Fluoxetine treatment was associated with greater reduction in depressive symptoms (p < 0.05). The 54 subjects who achieved binge abstinence improved more on all measures than the 62 subjects who did not. In particular, these subjects lost, on average, 6.2 kg compared with a gain of 0.7 kg among non-abstainers.Discussion: Adjunctive individual CBT results in significant additional binge reduction in obese binge eaters receiving standard behavioral weight control treatment.