Grilo Carlos M, Masheb Robin M
Department of Psychiatry, Yale University School of Medicine, 301 Cedar Street-2nd Floor, P.O. Box 208098, New Haven, CT 06520, USA.
Behav Res Ther. 2005 Nov;43(11):1509-25. doi: 10.1016/j.brat.2004.11.010.
We performed a randomized controlled study to test the relative efficacy of guided self-help (gsh) cognitive-behavioral therapy (CBTgsh) and behavioral weight loss treatment (BWLgsh) treatments for binge eating disorder (BED). To provide an additional partial control for non-specific influences of attention, a third control (CON) treatment condition was included. We tested the treatments using a guided self-help approach given the promising results from initial studies using minimal therapist guidance. Ninety consecutive overweight patients (19 males, 71 females) with BED were randomly assigned (5:5:2 ratio) to one of three treatments: CBTgsh (N=37), BWLgsh (N=38), or CON (N=15). The three 12-week treatment conditions were administered individually following guided self-help protocols. Overall, 70 (78%) completed treatments; CBTgsh (87%) and CON (87%) had significantly higher completion rates than BWLgsh (67%). Intent-to-treat analyses revealed that CBTgsh had significantly higher remission rates (46%) than either BWLgsh (18%) or CON (13%). Weight loss was minimal and differed little across treatments. The findings suggest that CBT, administered via guided self-help, demonstrates efficacy for BED, but not for obesity. The findings support CBT administered via guided self-help as a first step in the treatment of BED and provide evidence for its specific effects.
我们进行了一项随机对照研究，以测试指导性自助认知行为疗法（CBTgsh）和行为减肥疗法（BWLgsh）对暴饮暴食症（BED）的相对疗效。为了对注意力的非特异性影响提供额外的部分控制，纳入了第三种对照（CON）治疗条件。鉴于使用最少治疗师指导的初步研究取得了有前景的结果，我们采用指导性自助方法对这些治疗进行了测试。90名连续的患有BED的超重患者（19名男性，71名女性）被随机分配（比例为5:5:2）到三种治疗之一：CBTgsh（N = 37）、BWLgsh（N = 38）或CON（N = 15）。三种为期12周的治疗条件按照指导性自助方案分别进行。总体而言，70名（78%）患者完成了治疗；CBTgsh（87%）和CON（87%）的完成率显著高于BWLgsh（67%）。意向性分析显示，CBTgsh的缓解率（46%）显著高于BWLgsh（18%）或CON（13%）。体重减轻极少，且各治疗组之间差异不大。研究结果表明，通过指导性自助实施的CBT对BED有效，但对肥胖无效。这些发现支持将通过指导性自助实施的CBT作为BED治疗的第一步，并为其特定效果提供了证据。
