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Psychotherapies for eating disorders: findings from a rapid review

2023; BioMed Central; Volume: 11; Issue: 1 Linguagem: Inglês

10.1186/s40337-023-00886-w

2050-2974

Haley Russell, Phillip Aouad, Anvi Le, Peta Marks, Danielle Maloney, Phillip Aouad, Sarah Barakat, Robert A. Boakes, Leah Brennan, Emma Bryant, Susan M. Byrne, Belinda Caldwell, Shannon Calvert, Bronny Carroll, David Castle, Ian D. Caterson, Belinda Chelius, Lyn Chiem, Simon Clarke, Janet Conti, Lexi Crouch, Genevieve Dammery, Natasha Dzajkovski, Jasmine Fardouly, John Feneley, Nasim Foroughi, Mathew Fuller-Tyszkiewicz, Anthea Fursland, Veronica Gonzalez‐Arce, Bethanie Gouldthorp, Kelly Griffin, Scott Griffiths, Ashlea Hambleton, Amy Hannigan, Mel Hart, Susan Hart, Phillipa Hay, Ian B. Hickie, Francis Kay-Lambkin, Ross King, Michael Kohn, Eyza Koreshe, Isabel Krug, Jake Linardon, Randall Long, Amanda Long, Sloane Madden, Sarah Maguire, Danielle Maloney, Peta Marks, Siân A. McLean, Thy Meddick, Jane Miskovic‐Wheatley, Deborah Mitchison, Richard O’Kearney, Shu Hwa Ong, Roger Paterson, Susan J. Paxton, Melissa Pehlivan, Geneviève Pépin, Andrea Phillipou, Judith Piccone, Rebecca T. Pinkus, Bronwyn Raykos, Paul Rhodes, Elizabeth Rieger, Karen Rockett, Sarah Rodan, Janice Russell, Haley Russell, Fiona Salter, Susan M. Sawyer, Beth Anne Shelton, Urvashnee Singh, Sophie Smith, Evelyn Smith, Karen Spielman, Sarah Squire, Juliette Thomson, Marika Tiggemann, Stephen Touyz, Ranjani Utpala, Lenny R. Vartanian, Sabina Vatter, Andrew Wallis, Warren Ward, Sarah Wells, Eleanor H. Wertheim, Simon Wilksch, Michelle C. Williams, Stephen Touyz, Sarah Maguire,

Obsessive-Compulsive Spectrum Disorders

Abstract Background Psychotherapy is considered central to the effective treatment of eating disorders—focusing on behavioural, psychological, and social factors that contribute to the illness. Research indicates psychotherapeutic interventions out-perform placebo, waitlist, and/or other treatments; but, outcomes vary with room for major improvement. Thus, this review aims to (1) establish and consolidate knowledge on efficacious eating disorder psychotherapies; (2) highlight select emerging psychotherapeutic interventions; and (3) identify knowledge gaps to better inform future treatment research and development. Methods The current review forms part of a series of Rapid Reviews published in a special issue in the Journal of Eating Disorders to inform the development of the Australian-government-funded National Eating Disorder Research and Translation Strategy 2021–2031. Three databases were searched for studies published between 2009 and 2023, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, and population studies). Data pertaining to psychotherapies for eating disorders were synthesised and outlined in the current paper. Results 281 studies met inclusion criteria. Behavioural therapies were most commonly studied, with cognitive-behavioural and family-based therapies being the most researched; and thus, having the largest evidence-base for treating anorexia nervosa, bulimia nervosa, and binge eating disorder. Other therapies, such as interpersonal and dialectical behaviour therapies also demonstrated positive treatment outcomes. Emerging evidence supports specific use of Acceptance and Commitment; Integrative Cognitive Affective; Exposure; Mindfulness; and Emotionally-Focused therapies; however further research is needed to determine their efficacy. Similarly, growing support for self-help, group, and computer/internet-based therapeutic modalities was noted. Psychotherapies for avoidant/restrictive food intake disorder; other, and unspecified feeding and eating disorders were lacking evidence. Conclusions Currently, clinical practice is largely supported by research indicating that behavioural and cognitive-behavioural psychotherapies are most effective for the treatment of eating disorders. However, the efficacy of psychotherapeutic interventions varies across studies, highlighting the need for investment and expansion of research into enhanced variants and novel psychotherapies to improve illness outcomes. There is also a pressing need for investigation into the whole range of eating disorder presentations and populations, to determine the most effective interventions.