Comparison of treatment seeking compulsive buyers in Germany and the United States.

OBJECTIVE: The aim of this pilot study was to compare a German (Bavaria) and an American (North Dakota) sample of women suffering from compulsive buying. METHOD: Thirty-eight German and 39 American female compulsive buyers were screened with the Compulsive Buying Scale (CBS), and the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV) prior to entering a group treatment study. Psychiatric co-morbidity was assessed with the Structured Clinical Interview for DSM-IV Axis I disorders (SCID). RESULTS: There were no statistically significant differences between the German sample and the American sample with regard to age (mean 43.7 and 45 years, respectively), and with regard to the scores on the CBS and the Y-BOCS-SV. A high lifetime co-morbidity rate with Axis I disorders, especially mood disorders, anxiety disorders, substance use disorders, OCD, and binge eating disorder was detected in both samples. Almost all participants met criteria for at least one lifetime Axis I disorder. However, German compulsive buyers showed significantly higher current prevalence rates of any affective disorder, and higher current and lifetime prevalence rates of any anxiety disorder and somatoform disorder. In addition, German compulsive buyers were significantly more likely to have more than one Axis I disorder. CONCLUSION: The groups did not differ with regard to age and with regard to the severity of compulsive buying and showed a high co-morbidity with Axis I disorders. However, the German compulsive buying sample presented with significantly more psychiatric co-morbidity compared to the American sample. Further research is needed to provide a better understanding of this disorder in general and cross-culturally.

Cognitive behavioral therapy for compulsive buying disorder.

To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.

Dental practitioners and eating disorders.

To better understand how dental practitioners identify, counsel, and refer patients with eating disorders. A questionnaire was mailed to 625 dental practitioners, 54 (19%) of the dentists and 69 (20%) of the dental hygienists responded. Most dental practitioners were aware of eating disorder patients in their practices and most discussed their findings with their patients or parents. However, one of the suggestions most commonly given to patients, to brush immediately after vomiting, may be counter therapeutic, and a few offered referral for more health services. Collaboration between dental practitioners and mental health practitioners who work with eating disorder patients should be improved.

Effects of sibutramine on binge eating, hunger, and fullness in a laboratory human feeding paradigm.

OBJECTIVE: The purpose of this study was to evaluate the effects of sibutramine vs. placebo on binge-eating behavior, hunger, and satiety in patients who had problems with binge eating. RESEARCH METHODS AND PROCEDURES: Seven adult subjects who had problems with binge eating (mean age, 42 years) were randomly assigned to receive alternating sibutramine and placebo in a double-blind placebo-controlled crossover study. This involved two 4-week dosing periods separated by a 2-week washout. RESULTS: Subjects lost weight on sibutramine but not on placebo. There was a significant difference in the number of kilocalories consumed between the sibutramine and placebo conditions, with a significant reduction of intake during binge-eating episodes on sibutramine. DISCUSSION: Sibutramine suppresses intake during binge-eating episodes. This effect is demonstrable in a human feeding laboratory paradigm.

The eating disorders medicine cabinet revisited: a clinician's guide to appetite suppressants and diuretics.

OBJECTIVE: This article explores the frequencies of use of alternative medications, available products, and their potential toxicities. METHOD: Survey data were gathered from 39 consecutive patients diagnosed with bulimia nervosa who were seeking treatment. A survey of area outlets (health food stores, pharmacies, grocery stores) was conducted to establish a database of available agents. Putative active ingredients were identified. MEDLINE literature searches, as well as reviews of specialized texts, were performed to identify the potential toxicities of the ingredients. RESULTS: Diet pill use was found in 64% of patients; 18 % reported use in the past month. The survey identified 167 products. Diuretic use was found in 31% of patients; 21% reported use in the past month. Twenty-five diuretic products were identified. DISCUSSION: Alternative medicines are frequently used in the population of patients seeking treatment for bulimia nervosa. An abundance of products are available with potentially significant toxicities.

Eating behavior and other distracting behaviors while driving among patients with eating disorders.

The current study sought to better characterize eating behavior, binge-eating behavior, and other potentially problematic, distracting behaviors while driving in patients with eating disorders. Forty patients with eating disorders who reported eating in their car at least once per week were included. Thirty subjects with eating disorders reported binge-eating while driving. A surprisingly high number of subjects reported engaging in a variety of distracting behaviors, including changing clothes, reading, applying make-up, and combing/brushing their hair while driving. Potentially problematic behaviors such as binge-eating while driving should be inquired about during assessment, and if found should be addressed in treatment planning.

The relationship between compulsive buying and eating disorders.

OBJECTIVE: Compulsive buying has received increased research attention in the last decade. The disorder has high rates of comorbidity for other disorders, including eating disorders. This study explored the possible relationship between compulsive buying and eating disorders. METHOD: Twenty women who scored in the pathological range on a measure of compulsive buying and 20 controls were recruited via the media. Various measures of psychopathology and eating disorder symptoms were administered to both groups. RESULT: Compulsive buyers were significantly more likely to have a higher lifetime history of substance abuse or dependence. No differences existed between normal controls and compulsive buyers in prevalence of current or lifetime eating disorders, nor were there differences in scores of eating-related psychopathology. DISCUSSION: This work failed to demonstrate an increased risk for eating disorder in compulsive buyers, although a higher rate of substance dependence or abuse and higher scores on pathological personality dimension scales were seen.