Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome

Riesco, Nadine; Agüera, Zaida; Granero, Roser; Jiménez‐Murcia, Susana; Menchón, José M.; Fernández‐Aranda, Fernando

doi:10.1016/j.eurpsy.2018.08.001

Cited by 54 publications

(51 citation statements)

References 45 publications

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“…In the present study, participants were assessed and provided with psychoeducational materials designed to increase motivation, which may have increased engagement. Diagnosis also did not predict dropout, contrary to a recent evaluation finding higher dropout for other specified feeding and eating disorder compared with other diagnoses (Riesco et al, ). However, while a power analysis found the study to be sufficiently powered, smaller sample sizes in our diagnostic groups (e.g., those with AN, UFED, and BED, collaboratively decided to leave vs. dropout) limits power for analyses of subgroups.…”

Section: Discussioncontrasting

confidence: 92%

A pragmatic effectiveness study of 10‐session cognitive behavioural therapy (CBT‐T) for eating disorders: Targeting barriers to treatment provision

Pellizzer

Waller

Wade

2019

Euro Eating Disorders Rev

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Objective: Ten-session cognitive behavioural therapy (CBT-T) for transdiagnostic eating disorders targets several barriers to treatment, including cost, therapist expertise, and lengthy wait lists.Method: We used a case series design to investigate the effectiveness of CBT-T delivered by trainee psychologists in a postgraduate training clinic.Participants were randomly allocated to commence treatment either immediately or after a 4-week waitlist period. CBT-T was delivered to 52 patients, by six different trainees under supervision. Measures of eating disorder cognitions and behaviours, quality of life, and general psychopathology were examined in completer and intention-to-treat analyses using multilevel modelling. Last observation carried forward was applied for abstinence, remission, and good outcome analyses to aid comparison with prior studies.Results: Significant improvements, associated with medium to large effect sizes, were found for eating disorder cognitions, behaviours quality of life, and negative affect from baseline to posttreatment, and at 1-and 3-month followup. Attrition (38.5%) was comparable with other treatment studies.Conclusion: Results provide evidence for the effectiveness of CBT-T delivered by trainee psychologists for transdiagnostic eating disorder patients, thus tackling some important barriers for treatment. Longer follow-up, randomised controlled trial designs, and moderator analyses will provide more robust evidence about which patients do best with a shorter therapy.

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Section: Discussioncontrasting

confidence: 92%

A pragmatic effectiveness study of 10‐session cognitive behavioural therapy (CBT‐T) for eating disorders: Targeting barriers to treatment provision

Pellizzer

Waller

Wade

2019

Euro Eating Disorders Rev

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“…Although all the participants in the current study were FA+, we found that the identified clusters followed a linearity with respect to FA severity with the most dysfunctional clusters (1 and 2) having the highest FA symptoms level, and the most functional one, the lowest. For the “dysfunctional cluster”, we found a higher prevalence of OSFED and BN, both ED conditions characterized by more dysfunctional personality traits, greater impulsivity, and more general psychopathology, [54,55,56,57], as well by their worse prognosis [56]. Consistent with this literature, the cluster with more OFED and BN had the worst psychopathological state and highest severity in ED symptomatology.…”

Section: Discussionsupporting

confidence: 82%

Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment

et al. 2019

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Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.

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“…As described elsewhere [ 33 , 34 ], all patients received cognitive behavioral therapy (CBT) at HUB, which was carried out by clinical psychology experts in the field. The CBT group therapy intervention for bulimia nervosa (BN), binge eating disorder (BED) and other specified feeding or eating disorders (OSFED) consisted of 16 weekly outpatient sessions lasting 90 minutes each and a follow-up period of about two years’ duration that was carried out in a group format.…”

Section: Methodsmentioning

confidence: 99%

“…According to DSM-5 criteria [ 28 ], the definition of full remission is a total absence of symptoms meeting diagnostic criteria for at least 4 consecutive weeks; partial remission is defined as a substantial symptomatic improvement but with residual symptoms; and patients who present poor outcomes are defined as non-remission. These categories were previously used to assess treatment outcome in threshold ED in other published studies [ 33 , 34 ]. Voluntary treatment discontinuation was categorized as dropout (i.e., not attending treatment for at least three consecutive sessions).…”

Section: Methodsmentioning

confidence: 99%

Does ADHD Symptomatology Influence Treatment Outcome and Dropout Risk in Eating Disorders? A longitudinal Study

Testa

Baenas

Vintró-Alcáraz

et al. 2020

JCM

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Attention-deficit/hyperactivity disorder (ADHD) and its symptoms have been shown to be present in patients with eating disorders (EDs) and are associated with increased psychopathology and more dysfunctional personality traits. This study aimed to assess if the presence of ADHD symptoms in patients with EDs affects their short and long-term therapy outcome. A total of 136 consecutively treated ED patients were considered in this study. Baseline pre-treatment evaluation included the Adult ADHD Self-Report Scale (ASRS v1.1) for ADHD symptoms and the assessment of eating symptomatology using the Eating Disorders Inventory (EDI-2). Treatment outcome was evaluated in terms of ED symptoms after cognitive behavioral therapy (CBT) and dropout rate during treatment. Furthermore, we evaluated ED symptoms in treatment completers after a follow-up of 8 years on average. Path analyses assessed the potential mediational role of the EDI-2 total score in the relationship between ADHD and treatment outcome. Results showed that baseline symptoms of ADHD indirectly affected treatment outcome after CBT; the ASRS positive screening was related to higher eating symptomatology (standardized coefficient B = 0.41, p = 0.001, 95% CI: 0.26 to 0.55), and the presence of high ED levels contributed to the increase of dropout (B = 0.15, p = 0.041, 95% CI: 0.03 to 0.33) and a worse treatment outcome (B = 0.18, p = 0.041, 95% CI: 0.01 to 0.35). No direct effect was found between the ASRS positive screening with the risk of dropout (B = −0.08, p = 0.375) and worse treatment outcome (B = −0.07, p = 0.414). These results suggest the relevance of identifying specific treatment approaches for patients with ADHD symptoms and severe eating symptomatology.

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Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome

Abstract: our results suggest that OSFED patients may benefit similarly from the same CBT outpatient group approach. However, high dropout rates and low motivation seems to be an important limitation and challenge for future approaches.

Cited by 54 publications

References 45 publications

A pragmatic effectiveness study of 10‐session cognitive behavioural therapy (CBT‐T) for eating disorders: Targeting barriers to treatment provision

A pragmatic effectiveness study of 10‐session cognitive behavioural therapy (CBT‐T) for eating disorders: Targeting barriers to treatment provision

Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment

Does ADHD Symptomatology Influence Treatment Outcome and Dropout Risk in Eating Disorders? A longitudinal Study

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