CPG for Eating Disorders

Variable: reduction / remission of binge-eating and purgingThere is insufficient evidence to determine that there are clinically significantdifferences between SH and GSH in the remission of binge-eating by the end oftreatment (1 RCT, N=40; Loeb, 2000 260 ; RR: 0.71; 95% CI: 0.42 to1.21).There is limited evidence to determine that GSH is superior to SH in reducing thefrequency of binge-eating by the end of treatment (2 RCTs, N=109; Loeb, 2000 260 ;Carter,1998 261 ; SMD: -0.48; 95% CI: -0.86 to -0.09).There is insufficient evidence to determine that there are clinically significantdifferences between SH and GSH in the frequency of binge-eating at post-treatmentfollow-up (1 RCT, N=69; Carter, 1998 261 ; SMD: -0.24; 95% CI: -0.71 to 0.23).RCT1++RCT1++RCT1++Variables: depression and/or interpersonal and psychosocial functioning and/orgeneral psychiatric symptomsThere is insufficient evidence to determine that there are clinically significantdifferences between SH and GSH in depression scores by the end of treatment (1 RCT,N=40; Loeb, 2000 260 ; SMD: -0.22; 95% CI: -0.85 to 0.40).There is insufficient evidence to determine that there are clinically significantdifferences between SH and GSH in general psychiatric symptoms by the end oftreatment (2 RCTs, N=109; Loeb, 2000 260 ; Carter, 1998 261 ; SMD: -0.18; 95% CI: -0.55to 0.20) and at follow-up (1 RCT, N=69; Carter, 1998 261 ; SMD: -0.20; 95% CI: -0.68 to0.27).RCT1++RCT1++More resultsIn an RCT (Peterson, 1998; USA 256 ) SH administered by a therapist (G1) was comparedto partial SH (G2), structured SH (G3) and wait-list (G4) in 61 patients with BED. G1used group discussion and the psychoeducational component; in G2, participantswatched a 30-minute psychoeducational video and later engaged in a group discussionwith the therapist, and in G3 participants watched the 30-minute video and discussed itamongst themselves. All treated groups obtained better results than the control group inremission and frequency of binge-eating and symptoms related with eating disorders.Abstinence proportion (complete remission) was 68% to 87% in the treated groups and12.5% in the control group. There were no differences amongst groups in terms ofdepression and BMI.In an RCT (Peterson, 2001; USA) 255 SH administered by a therapist (G1) was comparedto partial SH (G2) and structured SH (G3) in 61 patients with BED. The three groupsshowed significant improvement in remission, binge-eating frequency and bodydissatisfaction. The SH group obtained greater remission by the end of treatment, butnot at follow-up. There were no differences amongst groups in terms of depression andBMI.RCT1+RCT1+115CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS