Yurkow Sydney, Ivezaj Valentina, Pittman Brian, Grilo Carlos M
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
Corresponding Author: Carlos M. Grilo, PhD, Yale University School of Medicine, 300 George St (9th floor), New Haven, CT 06511 (
J Clin Psychiatry. 2025 May 7;86(2):24m15552. doi: 10.4088/JCP.24m15552.
Efficacious treatments for binge-eating disorder (BED) have been identified, but research is lacking regarding patients' treatment preferences and their effects on outcomes. We investigated the frequency and correlates of patients' preferences for 2 distinct BED treatments-cognitive behavioral therapy (CBT) and lisdexamfetamine (LDX)-and whether preferences predicted and/or moderated outcomes. In a randomized controlled trial (performed March 2019 to September 2023) testing CBT and LDX for - defined BED, 102 participants indicated their preference after treatments were described and prior to beginning treatment. Treatment was randomly assigned (not influenced by preferences). Independent assessors, blinded to treatments and to patients' treatment preferences, performed outcome assessments. 43.1% (44/102) preferred LDX, 23.5% (24/102) preferred CBT, and 33.3% (34/102) reported no preference. Treatment preference was not significantly associated with any sociodemographic or baseline clinical characteristics. Logistic regression models (for binge-eating remission and attaining ≥5% weight loss) and mixed models (for changes in binge-eating frequency, weight, eating disorder psychopathology, and depression) testing main effects of treatments, main effects of treatment preferences, and their interaction effects converged. No significant interaction effects between treatment and treatment preferences were observed. In this study comparing CBT and LDX treatments for BED in patients with obesity, participants' preferences for treatments were not associated with their sociodemographic or clinical characteristics and did not moderate treatment outcomes of these 2 effective interventions. Implications for clinical practice and future research are discussed. ClinicalTrials.gov identifier: NCT03924193.
已确定了治疗暴饮暴食症（BED）的有效方法，但在患者的治疗偏好及其对治疗结果的影响方面缺乏研究。我们调查了患者对两种不同的BED治疗方法——认知行为疗法（CBT）和赖右苯丙胺（LDX）——的偏好频率及其相关因素，以及偏好是否能预测和/或调节治疗结果。在一项比较CBT和LDX治疗明确的BED的随机对照试验（于2019年3月至2023年9月进行）中，102名参与者在了解治疗方法后且在开始治疗前表明了他们的偏好。治疗是随机分配的（不受偏好影响）。独立评估人员在对治疗方法和患者的治疗偏好不知情的情况下进行了结果评估。43.1%（44/102）的人更喜欢LDX，23.5%（24/102）的人更喜欢CBT，33.3%（34/102）的人表示无偏好。治疗偏好与任何社会人口统计学或基线临床特征均无显著关联。用于检验治疗的主要效应、治疗偏好的主要效应及其交互效应的逻辑回归模型（用于暴饮暴食缓解和体重减轻≥5%）和混合模型（用于暴饮暴食频率、体重、饮食失调精神病理学和抑郁的变化）得出了一致结果。未观察到治疗与治疗偏好之间有显著的交互效应。在这项比较肥胖患者BED的CBT和LDX治疗的研究中，参与者对治疗的偏好与其社会人口统计学或临床特征无关，也未调节这两种有效干预措施的治疗结果。文中讨论了对临床实践和未来研究的启示。ClinicalTrials.gov标识符：NCT03924193。
