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Prognostic value of rapid response to enhanced cognitive behavioral therapy in a routine clinic sample of eating disorder outpatients

Authors

  • Bronwyn C. Raykos PhD,

    Corresponding author
    1. Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
    • Correspondence to: Bronwyn Raykos, Centre for Clinical Interventions, 223 James St, Northbridge, Western Australia, Australia 6003. E-mail: bronwyn.raykos@health.wa.gov.au

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  • Hunna J. Watson PhD,

    1. Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
    2. School of Paediatrics and Child Health, The University of Western, Australia
    3. Princess Margaret Hospital for Children, Department of Health in Western Australia, Perth, Australia
    4. School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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  • Anthea Fursland PhD,

    1. Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
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  • Susan M. Byrne PhD, DPhil,

    1. Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
    2. School of Psychology, The University of Western Australia, Perth, Australia
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  • Paula Nathan MPsych(Clin)

    1. Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia
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ABSTRACT

Objective

This study examined whether rapid response to enhanced cognitive behavioral therapy (CBT-E) was associated with superior treatment outcomes in a transdiagnostic sample of patients with an eating disorder.

Method

Participants were 105 patients with a primary eating disorder diagnosis who received individual CBT-E at a community-based outpatient clinic. Patients completed measures of eating disorder and related pathology at baseline and post-treatment. The Eating Disorder Examination-Questionnaire (EDE-Q) was administered at baseline and again, on average, 4.6 weeks after commencing treatment to assess rapid response to CBT-E. Patients achieving reliable change on the EDE-Q at this point were classified as rapid responders.

Results

No baseline differences distinguished rapid and nonrapid responders. Rapid responders had significantly lower scores on EDE-Q global at post-treatment, were more likely to achieve full remission, and required significantly fewer treatment sessions than nonrapid responders. One-quarter of the nonrapid responders went on to achieve full remission. There were no group differences on measures of anxiety and depression symptoms at the end of treatment.

Discussion

Early change in treatment is encouraged to achieve the best possible prognosis in CBT-E. Those who did not achieve rapid response still had an overall significant improvement in symptoms from pretreatment to post-treatment, but a lower rate of full remission. Nonrapid responders are an important group of patients to study because they offer researchers an opportunity to improve clinical decision-making and treatment outcomes for patients who are at risk of suboptimal response. © 2013 Wiley Periodicals, Inc.(Int J Eat Disord 2013; 46:764–770)

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