46 research outputs found
Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder
To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. Method: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSMâIV] and Fifth Edition [DSMâ5]), were retrieved and analyzed using random-effect modeling. Results: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitive-behavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitive-behavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short- and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. Conclusions: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care
Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder
To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. Method: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSMâIV] and Fifth Edition [DSMâ5]), were retrieved and analyzed using random-effect modeling. Results: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitive-behavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitive-behavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short- and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. Conclusions: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care
Supplementary Material for: The Effects of an Internet-Based Imagery Rehearsal Intervention: A Randomized Controlled Trial
<p><b><i>Background:</i></b> Nightmares are extremely dysphoric dreams,
which are prevalent and associated with psychological strain. This study
investigated (a) the efficacy of an internet-based imagery rehearsal
therapy (IRT), (b) the role of imagery rescription, and (c) the role of
guidance during internet-based IRT. <b><i>Methods:</i></b> A total of
127 patients suffering from mainly idiopathic nightmares were randomly
assigned to 1 of 2 IRT internet-based groups (guided IRT; unguided IRT)
or to 1 of 2 active control groups (frequency control group; narrative
control group). <b><i>Results:</i></b> IRT was more effective than a
nightmare frequency control condition with respect to nightmare
frequency and nightmare distress. Compared to the narrative control
group, IRT was only superior in improving nightmare distress but not in
nightmare frequency because the narrative control group also improved
regarding nightmare frequency. Guidance by a nightmare coach did not
affect efficacy, compliance, or dropout. <b><i>Conclusion:</i></b>
Internet-based IRT seems to be an effective treatment even when offered
with minimal guidance by a nightmare coach. Describing the nightmare
narrative in detail already decreased nightmare frequency. However, with
regard to inducing decreases in nightmare frequency and nightmare
distress, IRT was superior to the narrative control group. The results
are discussed with reference to the mastery hypothesis.</p