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01-12-2020 | Behavioural Therapy | Research

Effectiveness of enhanced cognitive behavior therapy for bulimia nervosa in Japan: a randomized controlled trial protocol

Authors: Chisato Ohara, Atsushi Sekiguchi, Shu Takakura, Yuka Endo, Naho Tamura, Hiroe Kikuchi, Kazushi Maruo, Norio Sugawara, Kenji Hatano, Hitomi Kawanishi, Misako Funaba, Ayako Sugawara, Nobuhiro Nohara, Keisuke Kawai, Shin Fukudo, Nobuyuki Sudo, Zafra Cooper, Kazuhiro Yoshiuchi, Tetsuya Ando

Published in: BioPsychoSocial Medicine | Issue 1/2020

Abstract

Background

The effectiveness of psychotherapeutic interventions for eating disorders (EDs) is widely studied in Europe, North America, and Australia/New Zealand. However, few controlled studies and no randomized controlled trials (RCTs) have been conducted in Japan despite the relatively high prevalence of EDs in the Japanese population. The aim of this study is to evaluate the effect of enhanced cognitive behavior therapy (CBT-E), an evidence-supported ED-focused form of cognitive behavior therapy (CBT), for the treatment of bulimia nervosa (BN) in Japan.

Methods/design

This multicenter RCT will compare CBT-E with treatment as usual (TAU), which is widely used in Japan. A group of 140 adult outpatients with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) diagnosis of BN, ≥18 years of age, a body mass index (BMI) > 17.5 and < 40 kg/m² will be randomly assigned to CBT-E or TAU. Participants will be stratified by intervention site and BN severity. CBT-E participants will receive 20 sessions of focused form CBT-E for 20 weeks. Those in the TAU group will receive routine treatment provided by specialists. Assessment will be performed in a blinded manner prior to the start of treatment, after 6 weeks of treatment, at the end of treatment (20 weeks), and at follow-up at 40 and 80 weeks after the start of treatment. The primary outcome is the remission of BN, defined by the absence, in the previous 4 weeks, of symptoms required to meet the DSM-5 criteria for a diagnosis of BN. Secondary outcomes include the levels of ED psychopathology and impairment due to the ED, anxiety, depression, family function, and satisfaction with treatment.

Discussion

This will be the first RCT conducted in Japan to compare CBT-E and TAU for the treatment of BN. If CBT-E is found to be more effective than TAU, then the evidence would support its wider use for patients with BN in Japan. Because it is possible to train therapists who do not possess extensive specialist experience, wider use is also likely to be practically feasible. In addition, demonstrating the effectiveness of CBT-E in Japan would demonstrate that it could be successfully extended to additional world cultures and regions.

Trial registration

UMIN, UMIN000031625. Registered 7 Mar 2018.

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Title: Effectiveness of enhanced cognitive behavior therapy for bulimia nervosa in Japan: a randomized controlled trial protocol
Authors: Chisato Ohara
Atsushi Sekiguchi
Shu Takakura
Yuka Endo
Naho Tamura
Hiroe Kikuchi
Kazushi Maruo
Norio Sugawara
Kenji Hatano
Hitomi Kawanishi
Misako Funaba
Ayako Sugawara
Nobuhiro Nohara
Keisuke Kawai
Shin Fukudo
Nobuyuki Sudo
Zafra Cooper
Kazuhiro Yoshiuchi
Tetsuya Ando
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Behavioural Therapy
Eating Disorder
Bulimia
Eating Disorder
Published in: BioPsychoSocial Medicine / Issue 1/2020
Electronic ISSN: 1751-0759
DOI: https://doi.org/10.1186/s13030-020-0174-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effectiveness of enhanced cognitive behavior therapy for bulimia nervosa in Japan: a randomized controlled trial protocol

Abstract

Background

Methods/design

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods/design

Discussion

Trial registration

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