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Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base

OBJECTIVE: To map and examine the systematic review evidence base regarding the effects of cognitive‐behavioral therapy (CBT) for eating disorders (EDs), especially against active interventions. METHOD: This systematic review is an extension of an overview of CBT for all health conditions (CBT‐O). W...

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Autores principales: Kaidesoja, Milla, Cooper, Zafra, Fordham, Beth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092269/
https://www.ncbi.nlm.nih.gov/pubmed/36315392
http://dx.doi.org/10.1002/eat.23831
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author Kaidesoja, Milla
Cooper, Zafra
Fordham, Beth
author_facet Kaidesoja, Milla
Cooper, Zafra
Fordham, Beth
author_sort Kaidesoja, Milla
collection PubMed
description OBJECTIVE: To map and examine the systematic review evidence base regarding the effects of cognitive‐behavioral therapy (CBT) for eating disorders (EDs), especially against active interventions. METHOD: This systematic review is an extension of an overview of CBT for all health conditions (CBT‐O). We identified ED‐related systematic reviews from the CBT‐O database and performed updated searches of EMBASE, MEDLINE, and PsychInfo in April 2021 and September 2022. RESULTS: The 44 systematic reviews included (21 meta‐analyses) were of varying quality. They focused on “high intensity” CBT, delivered face‐to‐face by qualified clinicians, in BN, BED and mixed, not specifically low‐weight samples. ED‐specific outcomes were studied most, with little consensus on their operationalization. The, often insufficient, reporting of sample characteristics did not allow assessment of the generalizability of findings. The meta‐analytic syntheses show that high intensity one‐to‐one CBT produces better short‐term effects than a mix of active controls especially on ED‐specific measures for BED, BN, and transdiagnostic samples. There is little evidence favoring group CBT or low intensity CBT against other active interventions. DISCUSSION: While this study found evidence consistent with current ED treatment recommendations, it highlighted notable gaps that need to be addressed. There were insufficient data to allow generalizations regarding sex and gender, age, culture and comorbidity and to support CBT in AN samples. The evidence for group CBT and low intensity CBT against active controls is limited, as it is for the longer‐term effects of CBT. Our findings identify areas for future innovation and research within CBT. PUBLIC SIGNIFICANCE: This study provides a comprehensive mapping and quality assessment of the current large systematic review research base regarding the effects of cognitive behavioral therapy (CBT) for eating disorders (EDs), with a focus on comparisons to other active interventions. By transcending the more limited scope of individual systematic reviews, this overview highlights the gaps in the current evidence base, and thus provides guidance for future research and clinical innovation.
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spelling pubmed-100922692023-04-13 Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base Kaidesoja, Milla Cooper, Zafra Fordham, Beth Int J Eat Disord Reviews OBJECTIVE: To map and examine the systematic review evidence base regarding the effects of cognitive‐behavioral therapy (CBT) for eating disorders (EDs), especially against active interventions. METHOD: This systematic review is an extension of an overview of CBT for all health conditions (CBT‐O). We identified ED‐related systematic reviews from the CBT‐O database and performed updated searches of EMBASE, MEDLINE, and PsychInfo in April 2021 and September 2022. RESULTS: The 44 systematic reviews included (21 meta‐analyses) were of varying quality. They focused on “high intensity” CBT, delivered face‐to‐face by qualified clinicians, in BN, BED and mixed, not specifically low‐weight samples. ED‐specific outcomes were studied most, with little consensus on their operationalization. The, often insufficient, reporting of sample characteristics did not allow assessment of the generalizability of findings. The meta‐analytic syntheses show that high intensity one‐to‐one CBT produces better short‐term effects than a mix of active controls especially on ED‐specific measures for BED, BN, and transdiagnostic samples. There is little evidence favoring group CBT or low intensity CBT against other active interventions. DISCUSSION: While this study found evidence consistent with current ED treatment recommendations, it highlighted notable gaps that need to be addressed. There were insufficient data to allow generalizations regarding sex and gender, age, culture and comorbidity and to support CBT in AN samples. The evidence for group CBT and low intensity CBT against active controls is limited, as it is for the longer‐term effects of CBT. Our findings identify areas for future innovation and research within CBT. PUBLIC SIGNIFICANCE: This study provides a comprehensive mapping and quality assessment of the current large systematic review research base regarding the effects of cognitive behavioral therapy (CBT) for eating disorders (EDs), with a focus on comparisons to other active interventions. By transcending the more limited scope of individual systematic reviews, this overview highlights the gaps in the current evidence base, and thus provides guidance for future research and clinical innovation. John Wiley & Sons, Inc. 2022-10-31 2023-02 /pmc/articles/PMC10092269/ /pubmed/36315392 http://dx.doi.org/10.1002/eat.23831 Text en © 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Kaidesoja, Milla
Cooper, Zafra
Fordham, Beth
Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title_full Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title_fullStr Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title_full_unstemmed Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title_short Cognitive behavioral therapy for eating disorders: A map of the systematic review evidence base
title_sort cognitive behavioral therapy for eating disorders: a map of the systematic review evidence base
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092269/
https://www.ncbi.nlm.nih.gov/pubmed/36315392
http://dx.doi.org/10.1002/eat.23831
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