4 - (OP22) Predictors of Response to Therapy for Binge Eating Disorder

In an earlier randomised controlled trial, we compared three therapies; traditional CBT, CBT augmented with an appetite focus, and schema therapy for binge eating disorder. The results showed no significant differences in outcome between the three therapies at the end of treatment and at the 12 month follow-up. At the end of treatment 49% of the sample were abstinent from binge eating (BE). At end treatment 60% and at 12 month follow up 64% were considered recovered (McIntosh 2016).

While the results of this study indicated overall equality in response, across the three treatments for BE, an important question remains unanswered; are there patient characteristics associated with response in general, but also that are differentially associated with treatment type. The identification of differential predictors of response would help us predict which therapy modality is likely to more (or less) effective for a particular person, thereby providing a more targeted approach. The aim of this study is to investigate a variety of baseline patient characteristics that could predict response to the three therapies in the aforementioned trial.

The 112 participants in this study were recruited from general practioners, other health professionals and by advertisements. Inclusion criteria were female, age 16-65 and a primary binge eating diagnoses (DSMIV). Participants were randomised to one of the three therapies after the pretreatment assessments were completed. Therapy consisted of 6 months of weekly individual sessions followed by 6 months of monthly sessions. Treatment integrity was monitored closely via weekly supervision and ratings of random therapy sessions with validated competency and adherence scales.

Predictors of response for this study were demographic (age, marital status), clinical (severity, age of onset and chronicity of BE, BMI, shape and weight concerns, comorbidity), cognitive (dysfunctional attitudes, self-esteem, reasons for BE, perfectionism), functioning (social work, interpersonal), personality (personality and personality disorder symptoms) and treatment (treatment type and treatment credibility). Outcome variables were frequency of BE (percent change) and recovery from BE (within one SD community norms EDE global) at the end of 12 months of treatment.

The results show that change in binge eating frequency was predicted by baseline clinical and cognitive variables and recovery from BE (abstinence) was predicted by baseline demographic, clinical and cognitive factors. There was also some indication of therapy type differences. The detailed findings of this study will be described in this presentation and implications for treatment of binge eating disorder highlighted.