title: Prognostic value of rapid response to enhanced cognitive behavioral therapy in a routine clinic sample of eating disorder outpatients.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Clinical Interventions, Department of Health in Western Australia, Perth, Australia.
authors.forename: Bronwyn C
authors.initials: BC
authors.lastname: Raykos
authors.forename: Hunna J
authors.initials: HJ
authors.lastname: Watson
authors.forename: Anthea
authors.initials: A
authors.lastname: Fursland
authors.forename: Susan M
authors.initials: SM
authors.lastname: Byrne
authors.forename: Paula
authors.initials: P
authors.lastname: Nathan
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D001068:Feeding and Eating Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology*; D011379:Prognosis; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014904:Western Australia; D055815:Young Adult
keywords: eating disorders; enhanced cognitive behavioral therapy; rapid response