Table 2.
Author | N (% female) | Recruitment source | Diagnostic/inclusion criteria | Exclusion criteria | Tx conditions (duration and setting) | Primary outcome assessed | Secondary outcome assessed | Primary results | Secondary results |
---|---|---|---|---|---|---|---|---|---|
Psychopharmacological Interventions | |||||||||
Antidepressants | |||||||||
Fluoxetine | |||||||||
Walsh et al.50 | 22 (100) | Poor responders to outpatient CBT or IPT | DSM-III-R BNp | 8 weeks Outpatient 60 mg
|
Binge, purge episodes in last month, EDE, TFEQ | RSES, BMI, BDI | FLX > PL | FLX = PL | |
Romano et al.49 | 150 (98) | Outpatient FLX treatment responders | DSM-IV BNp > 18 | Serious psychiatric condition, previous external treatment >4 weeks | 52 weeks outpatient relapse prevention 60 mg
|
Time to relapse, binge/purge frequency, YCB-EDS | CGI, PGI | FLX > PL | FLX > PL |
Fluvoxamine | |||||||||
Milano et al.44 | 12 (100) | DSM-IV BN | 12 weeks Outpatient 200 mg
|
Binge/purge episodes | Body weight | FLV > PL | FLV > PL | ||
Sertraline | |||||||||
Milano et al.46 | 20 (100) | Outpatient | DSM-IV BNp 24–36 years old | 12 weeks Outpatient 100 mg
|
Binge/purge episodes | % body weight reduction | SER > PL | SER > PL | |
Psychosocial Interventions | |||||||||
Interpersonal Psychotherapy | |||||||||
Agras et al.54 | 220 (–) | Outpatient | DSM-III-R BNp, >18 years old | Severe psychical or psychiatric condition, current AN, current tx, pregnancy | 19 sessions Outpatient
1 year follow-up |
Recovery and remission rate, binge/purge frequency, EDE | SCL-90-R, RSES, IIP, SAS | CBT > IPT on % remitted and recovered, binge/purge frequency, dietary restraint At follow-up: CBT= IPT | CBT = IPT At follow-up: CBT = IPT |
Cognitive Behavioral Therapy | |||||||||
Agras et al.54 | 220 (–) | Outpatient | DSM-III-R BNp, >18 years old | Severe psychical or psychiatric condition, current AN, current tx, pregnancy | 19 sessions Outpatient
1 year follow-up |
Recovery and remission rate, binge/purge frequency, EDE | SCL-90-R, RSES, IIP, SAS | CBT > IPT on % remitted and recovered, binge/purge frequency, dietary restraint At follow-up: CBT = IPT | CBT = IPT At follow-up: CBT = IPT |
Carter et al.61 | 85 (100) | Waitlist for tx at hospital-based clinic | DSM-IV BNp (≥1 episode/week) | <17 years old, pregnant, medical illness, current psychosocial tx, BMI <18 | 8 weeks
|
Frequency of binge and compensatory behaviors, EDI, EDE | RSES, BDI, IIP | CBTsh = NSTsh = WL Simple time effects: CBTsh and NSTsh both had significant decreases in binge/compensatory behaviors over time; WL did not | CBTsh = NSTsh = WL |
Bailer et al.59 | 81 (–) | Community outpatient | DSM-IV BNp >17 years old | Medical instability, severe suicidality | 18 weeks Outpatient
1 year follow-up |
Monthly frequency of binge/purge episodes, EDI | BDI | gCBT = GSH At follow-up: Guided self-help > gCBT in remission rate |
gCBT= GSH |
Schmidt et al.56 | 85 (–) | Community referrals | DSM-IV BN or EDNOS (<2 episodes per week; or purging only), 13–20 years old | BMI < 10th percentile, substance dependence, severe mental illness | 13 weeks Outpatient
|
Abstinence from binge eating, vomiting, EATATE, EDE, ORFI | Health costs | CBTgsh > FT on abstinence of binge eating at 6 months CBTgsh = FT on abstinence of binge eating at 12 months, purging at 6, 12 months | CBTgsh = FT |
Dialectical Behavior Therapy | |||||||||
Safer et al.65 | 31 (100) | Community | Adapted DSM-IV BNp (≥1 episode/week), 18–65 years old | BMI < 17.5, psychosis, suicidality, active drug/alcohol abuse, concurrent tx | 20 sessions Outpatient
|
Frequency of binge/purge episodes | BDI, NMRS, EES, multi-dimensional personality scale, PANAS, RSES | DBT > WL | DBT = WL |
Weight Loss Treatment | |||||||||
Burton and Stice132 | 85 (100) | University and community outpatient | Adapted DSM-IV BN (≥1 episode/week), 18–55 years old | Treatment in past month, BMI < 19, serious medical or psychiatric condition | Outpatient 6 sessions
|
Remission status, binge/compensatory episodes (EDE) | BMI, SAS, health care utilization scale | HDI > WL | HDI > WL for reduction in BMI, health care utilization |
Family Based Therapy | |||||||||
LeGrange et al.68 | 80 (–) | Community and outpatient referrals | DSM-IV BN (≥1 episode/week) for 6 months, 12–19 years old | Substance dependence, BMI < 17.5 | 20 sessions outpatient
|
Remission rate (EDE) | K-SADS, BDI, RSES, tx suitability | FT > SPT | FT> SPT on vomiting, compensatory behavior frequency, EDE subscales |
Schmidt et al.56 | 85 (–) | Community referrals | DSM-IV BN or EDNOS (<2 episodes per week; or purging only), 13–20 years old | BMI < 10th percentile, substance dependence, severe mental illness | 13 weeks Outpatient
|
Abstinence from binge eating, vomiting, EATATE, EDE | ORFI, health costs | CBTgsh > FT on abstinence of binge eating at 6 months CBTgsh = FT on abstinence of binge eating at 12 months, purging at 6, 12 months | CBTgsh = FT |
Psychopharmacological + Psychosocial Interventions | |||||||||
Mitchell et al.71 | 91 (100) | Community and outpatient clinic | DSM-III-R BN (≥3 episodes/week) >18 years old, >85% IBW | Serious medical condition, adverse reaction to fluoxetine | 16 weeks Outpatient
|
Frequency of binge, vomit episodes, EDQ, EDI | HRSD, CGI, PGI | FLX > PL on vomiting SH + FLX, SH +PL > FLX, PL on vomiting | FLX > PL on CGI, PGI |
Walsh et al.72 | 91 (100) | Community | DSM-IV BNp (≥1 episode/week), 18–60 years old, BMI > 17.5 | Pregnancy, serious medical or psychiatric illness, concurrent tx | 16 weeks Outpatient
|
Frequency of binge, vomit episodes, EDE | BDI, SCL-53, | FLX > PL On frequency of binge, vomit episodes, EDE dietary restraint CBTgsh = FLX | FLX > PL CBTgsh = FLX |
Note: Greater than symbol (>) refers to significantly better outcome.
Abbreviations: AN, Anorexia Nervosa; BDI, Beck Depression Inventory; BED, Binge Eating Disorder; BMI, Body Mass Index; BN, Bulimia Nervosa; BT, Behavior Therapy; CBT, Cognitive Behavioral Therapy; CGI, Clinical Global Impression; CTRL, Control group; DBT, Dialectical Behavior Therapy; EDI, Eating Disorders Inventory; EDE, Eating Disorders Examination; EES, Emotional Eating Scale; FLX, Fluoxetine; FLV, Fluvoxamine; FT, Family-Based Therapy; g, Group Therapy; gsh, Guided Self Help; HDI, Healthy Diet Intervention; HRSD, Hamilton Rating Scale for Depression; IIP, Inventory of Interpersonal Problems; IMP, Imipramine; IPT, Interpersonal Psychotherapy; K-SADS, Kiddie Schedule of Affective Disorders; NMRS, Negative Mood Regulation Scale; ORFI, Oxford Risk Factor Inventory; NST, Nonspecific Supportive Therapy; PANAS, Positive and Negative Affectivity Scale; PL, Placebo; PGI, Patient Global Improvement; RSES, Rosenberg Self Esteem Scale; SAS, Weissman Social Adjustment Scale; SCL-90, Symptom Checklist; SER, Sertraline; SH, Self Help; SIB, Sibutramine; SM, Self-Monitoring; SPT, Supportive Psychotherapy; TFEQ, Three Factor Eating Questionnaire; TOP, Topiramate; VAS, Visual Analog Scale; WL, Wait List Control; YCB-EDS, Yale Cornell Brown Eating Disorder Scale.