Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA.
Int J Eat Disord. 2021 Aug;54(8):1555-1559. doi: 10.1002/eat.23569. Epub 2021 Jun 17.
A substantial proportion of patients with binge-eating disorder (BED) do not derive sufficient benefits from available evidence-based psychological interventions. We examined depression scores as predictors and moderators of response to cognitive-behavioral therapy (CBT) and behavioral weight-loss (BWL) for BED. We explored associations between changes in depression scores and changes in treatment outcomes.
Ninety adults with BED with obesity were randomized to CBT or BWL (6 months) and were evaluated independently throughout treatment, at posttreatment, and 12-month follow-up after treatments (18 months post-randomization). Pre-treatment depression scores, early changes in depression, and changes in depression from pre- to post-treatment were tested as predictors/moderators of outcomes (binge-eating frequency and eating-disorder psychopathology).
Baseline depression scores did not predict nor moderate outcomes at post-treatment or 12-month follow-up. Changes in depression scores (both early and throughout treatment) were not associated significantly with changes in binge-eating frequency or eating-disorder psychopathology at post-treatment or 12-month follow-up.
Findings suggest depression scores do not predict nor moderate acute- or longer-term outcomes in patients with BED receiving CBT or BWL. Findings reinforce need to improve treatments for BED overall, although they provide confidence that patients with elevated depression scores derive benefits from existing CBT and BWL interventions.
暴食症（BED）患者中有相当一部分人无法从现有的基于证据的心理干预措施中获得足够的益处。我们研究了抑郁评分作为认知行为疗法（CBT）和行为体重减轻（BWL）治疗 BED 反应的预测因子和调节剂的作用。我们探讨了抑郁评分变化与治疗结果变化之间的关联。
90 名患有肥胖症的 BED 成年人被随机分为 CBT 或 BWL（6 个月）组，并在整个治疗过程中、治疗结束时以及治疗后 12 个月（随机分组后 18 个月）进行独立评估。将治疗前的抑郁评分、抑郁的早期变化以及治疗前至治疗后的抑郁变化作为结局（暴食频率和饮食障碍心理病理学）的预测因子/调节剂进行测试。
基线抑郁评分既不能预测治疗结束时的结局，也不能预测 12 个月随访时的结局。抑郁评分的变化（早期和整个治疗过程中的变化）与治疗结束时和 12 个月随访时暴食频率或饮食障碍心理病理学的变化均无显著相关性。
研究结果表明，在接受 CBT 或 BWL 治疗的 BED 患者中，抑郁评分既不能预测急性或长期结局，也不能调节这些结局。研究结果强化了需要改进 BED 的整体治疗方法，但也表明，抑郁评分较高的患者确实能从现有的 CBT 和 BWL 干预措施中获益。
