School of Psychology, Australian Catholic University.
School of Psychology, Flinders University.
J Consult Clin Psychol. 2017 Nov;85(11):1080-1094. doi: 10.1037/ccp0000245.
This meta-analysis examined the efficacy of cognitive-behavioral therapy (CBT) for eating disorders.
Randomized controlled trials of CBT were searched. Seventy-nine trials were included.
Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies.
CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record
本荟萃分析考察了认知行为疗法（CBT）治疗饮食障碍的疗效。
搜索了 CBT 的随机对照试验。纳入了 79 项试验。
在神经性贪食症和暴食障碍患者中，治疗师主导的 CBT 比非活动（等待名单）和活动（任何心理治疗）对照更有效。当实施手册化的 CBT-BN 或其增强版本时，治疗师主导的 CBT 最为有效。在治疗后，治疗师主导的 CBT 治疗神经性贪食症和暴食障碍与抗抑郁药之间没有观察到显著差异。CBT 还与其他特定的心理干预措施进行了直接比较，在治疗后，治疗师主导的 CBT 导致行为和认知症状的减少幅度大于人际心理治疗。在随访时，CBT 仅在认知症状上优于人际心理治疗。暴食障碍的 CBT 也导致行为症状的减少幅度大于行为减肥干预。没有证据表明 CBT 比行为疗法或非特定支持性疗法更有效。
CBT 对饮食障碍有效。虽然 CBT 与某些心理治疗同样有效，但 CBT 与所有活动的心理对照和人际心理治疗的表现均优于其他治疗，这为心理治疗对饮食障碍的特异性提供了一些支持。本研究的结论受到许多试验质量较差的限制。高质量的 RCT 至关重要。
