Psychoeducation in Binge Eating Disorder and EDNOS: a pilot study on the efficacy of a 10-week and a 1-year continuation treatment

Abstract

Objective

The goals of the present study were (a) to analyse the efficacy of short-term (10 weeks) psychoeducation group treatment in patients with binge eating disorder (BED) and eating disorders not otherwise specified (EDNOS), and (b) to analyse the determinants of the success of psychoeducation on single outcome measures.

Methods

The sample included all patients seeking help for their binge behaviour at the Psychiatric Clinic of the Teaching Hospital of Udine. They all met the inclusion DSM-IV TR criteria for a diagnosis of EDNOS or BED. Eating attitudes were measured with the Eating Disorder Inventory (EDI-2), which includes three scales: bulimia (EDI-BU), body dissatisfaction (EDI-BD) and drive to thinness (EDI-DT). Other psychometric instruments were the Hospital Anxiety and Depression Scale and the Toronto Alexithymia Scale (TAS-20). Psychoeducation group treatment was carried out in an outpatient setting. It consisted in 10 weekly sessions of group therapy. At the end of this period, patients who maintained an eating disorder (ED) were asked to participate to an extension protocol, which included two fortnightly sessions followed by further monthly sessions for a period of 8 months.

Results

98 patients were originally included in the protocol. Of these, 54 met the criteria for BED and 44 for EDNOS. At the end of the treatment, 30 patients (30.6 %) no longer suffered from an ED. All patients showed significant improvements on several other outcome measures (frequency of binges, BMI, bulimic traits, body dissatisfaction, anxiety, depression and alexithymia). The probability to recover from an ED was greater in subjects with higher scores of both BMI (p = 0.009) and EDI-BU (p = 0.002), together with lower TAS-20 scores at t0 (p = 0.003); the probability to reduce the frequency of binges was greater in subjects with higher frequency of binges at t0 (p < 0.0001); the improvement in the EDI-BD scores was negatively associated (p = 0.005) with BMI at t0, and positively associated with scores at t0 of EDI-BD (p < 0.0001); the improvement in the EDI-BU scores at t1 was associated with the EDI-BU scores at t0 (p < 0.0001). 53 patients accepted to participate to the continuation phase; of these, 32 were assessed at the end of the period. About 41 % of the latter obtained a recovery from an ED, with a further reduction of the episodes of binges and an improvement of BMI scores.

Conclusion

This study may demonstrate the efficacy of psychoeducation group treatment for BED and EDNOS patients.