Dialectical behavior therapy compared to cognitive behavior therapy in binge-eating disorder: An effectiveness study...

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Therapy

Background:

• Binge-eating disorder (BED) is a significant mental health concern.
• Cognitive Behavior Therapy (CBT+) is an established treatment for BED.
• Dialectical Behavior Therapy for BED (DBT-BED) is an alternative therapeutic approach.

Purpose of the Study:

• To assess if previous quasi-randomized study findings comparing DBT-BED and CBT+ for BED are replicated in a nonrandomized effectiveness study.
• To evaluate treatment outcomes in a patient population representative of everyday clinical practice.

Main Methods:

• A nonrandomized study included 175 patients with BED (subthreshold included).
• Participants received either DBT-BED (n=42) or CBT+ (n=133) in a community eating disorder service.
• Outcomes measured included eating disorder pathology, emotion regulation, and general psychopathology at end of treatment and 6-month follow-up, analyzed using generalized linear models with multiple imputation.

Main Results:

• Both DBT-BED and CBT+ demonstrated substantial reductions in primary and secondary outcome measures.
• Cognitive Behavior Therapy (CBT+) showed statistically significant, medium-size differences favoring it in global eating disorder psychopathology at end of treatment (d=-0.62) and depressive symptoms at follow-up (d=-0.45).
• Treatment dropout rates were similar between groups (15.0% for CBT+ vs. 19.0% for DBT-BED, nonsignificant difference).

Conclusions:

• While CBT+ led to faster decreases in eating disorder psychopathology, overall improvements in DBT-BED were comparable.
• Original trial findings favoring CBT+ were not consistently replicated.
• DBT-BED is a relevant and potentially less time-intensive treatment option for BED in clinical practice, with similar dropout rates to CBT+.