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致 Grilo 等人(2015 年)的勘误。

Correction to Grilo et al. (2015).

出版信息

J Consult Clin Psychol. 2015 Aug;83(4):747. doi: 10.1037/ccp0000043.

Abstract

UNLABELLED

Reports an error in "Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response" by Carlos M. Grilo, Marney A. White, Robin M. Masheb and Ralitza Gueorguieva (Journal of Consulting and Clinical Psychology, 2015[Apr], Vol 83[2], 387-394). The axis labels are missing on Figure 3. A corrected figure appears in the correction. (The following abstract of the original article appeared in record 2015-02674-001.)

OBJECTIVE

We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing antiobesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings.

METHOD

One hundred four obese patients with BED were randomly assigned to 1 of 4 treatments: sibutramine, placebo, shCBT + sibutramine, or shCBT + placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research clinicians monthly throughout treatment, posttreatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge eating by the fourth treatment week, was used to predict outcomes.

RESULTS

Rapid response characterized 47% of patients, was unrelated to demographic and baseline clinical characteristics, and was significantly associated, prospectively, with remission from binge eating at posttreatment (51% vs. 9% for nonrapid responders), 6-month (53% vs. 23.6%), and 12-month (46.9% vs. 23.6%) follow-ups. Mixed-effects model analyses revealed that rapid response was significantly associated with greater decreases in binge-eating or eating-disorder psychopathology, depression, and percent weight loss.

DISCUSSION

Our findings, based on a diverse obese patient group receiving medication and shCBT for BED in primary-care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatment. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes, even in low-intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov: NCT00537810

摘要

未标注

报告在“预测初级保健中暴食障碍药物和自助治疗的有意义结果:早期快速反应的意义”中存在错误,作者为 Carlos M. Grilo、Marney A. White、Robin M. Masheb 和 Ralitza Gueorguieva(《咨询与临床心理学杂志》,2015[4 月],第 83 卷[2],第 387-394 页)。图 3 的坐标轴标签缺失。已在更正中添加正确的图表。(原始文章的以下摘要出现在记录 2015-02674-001 中。)

目的

我们在一项随机临床试验中检验了肥胖的暴食障碍(BED)患者的快速反应,该试验测试了抗肥胖药物和自我帮助认知行为疗法(shCBT)单独和联合治疗在初级保健环境中的效果。

方法

104 名肥胖的 BED 患者被随机分配到 4 种治疗方法之一:西布曲明、安慰剂、shCBT+西布曲明或 shCBT+安慰剂。治疗由全科初级保健医生提供,药物采用双盲。经过培训和监测的博士研究临床医生每月在整个治疗期间、治疗后(4 个月)以及治疗后 6 个月和 12 个月(即随机分组后 16 个月)进行独立评估。快速反应定义为第 4 周暴食减少≥65%,用于预测结果。

结果

快速反应占患者的 47%,与人口统计学和基线临床特征无关,并且与治疗后(51%比非快速反应者的 9%)、6 个月(53%比 23.6%)和 12 个月(46.9%比 23.6%)的暴食缓解显著相关。混合效应模型分析显示,快速反应与暴食或饮食障碍病理学、抑郁和体重减轻百分比的显著减少有关。

讨论

我们的研究结果基于在初级保健环境中接受药物和 shCBT 治疗 BED 的多样化肥胖患者群体,表明在治疗结束后 12 个月的随访中,快速反应的患者可以获得良好的临床结果。快速反应是临床有意义结果的有力预后指标,即使在低强度药物和自我帮助干预措施中也是如此。快速反应对 BED 的阶梯式护理治疗模型具有重要的临床意义。

临床试验注册

clinicaltrials.gov:NCT00537810

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