A 12-Week Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Topiramate for the Treatment of Compulsive Buying Disorder.

BACKGROUND: Topiramate is an anticonvulsant that has shown promise as a pharmacological agent for the treatment of addictive disorders, including compulsive buying disorder (CBD). The aim of the present study was to examine the efficacy of topiramate in the treatment of CBD and its associated characteristics using a 12-week randomized, double-blind, placebo-controlled design. METHODS: Fifty patients seeking treatment of CBD who met the inclusion criteria were randomly assigned to either the experimental group (n = 25) or the control group (n = 25). Both groups received 4 sessions of psychoeducation. RESULTS: Forty-four participants completed the follow-up with no differences in the rate of dropout between groups. There were no differences between participants who received topiramate or placebo in reducing CBD symptoms assessed by the primary outcome scale (Yale-Brown Obsessive-Compulsive Scale - Shopping Version). However, participants who received topiramate were significantly more likely to show clinical improvement when assessed by a secondary outcome measure, the Compulsive Buying Follow-Up Scale. In addition, there was a trend among participants who received topiramate to report improvements in aspects of hoarding and impulsivity compared with the control group. There were significant improvements in comorbid depression and social adjustments over time, but no group × time interaction was found. CONCLUSIONS: The results do not provide support for the use of topiramate in the treatment of CBD. Future investigation with larger and representative samples and longer follow-up period are needed.

Development and validation of the compulsive-buying follow-up scale: A measure to assess treatment improvements in compulsive buying disorder.

The aim of the present research was to develop a scale to assess treatment improvements for compulsive buying disorder (CBD), adapted from the Gambling Follow-up Scale Self-Report Version. The Compulsive Buying Follow-up Scale (CBFS) contains six self-report multiple-choice items assessing different aspects of compulsive buying in the past four weeks. Forty-eight treatment-seeking patients with CBD were evaluated, with 39 patients completing the 12-week follow-up. The scale's global alpha was high as well as the item-total correlations per item. The estimations of alpha if-item-deleted were all under the global alpha value, indicating that all items provided relevant contribution within the scale. The CBFS demonstrated significant correlations with previously developed scales of CBD and other measures of psychopathology, with the exception of a non-significant association with the Beck Depression Inventory at pre-treatment. The CBFS correlated significantly with all reference scales at post-treatment. The CBFS also demonstrated strong sensitivity to change and recovery status. The cutoff for the CBFS that provided the greatest sensitivity (0.93) and specificity (0.82) was 22. The results provide support that CBFS is a reliable and valid instrument to measure treatment outcomes over time for CBD.

The need to consume: Hoarding as a shared psychological feature of compulsive buying and binge eating.

INTRODUCTION: Compulsive buying and binge eating are two frequently co-occurring psychiatric conditions. Hoarding, which is the psychological need to excessively gather and store items, is frequently associated with both compulsive buying severity and binge eating severity. In the present study, we explored whether different dimensions of hoarding are a shared feature of compulsive buying and binge eating. METHOD: Participants consisted of 434 people seeking treatment for compulsive buying disorder. Registered psychiatrists confirmed the diagnosis of compulsive buying through semi-structured clinical interviews. Participants also completed measures to assess compulsive buying severity, binge eating severity, and dimensions of hoarding (acquisition, difficulty discarding, and clutter). Two-hundred and seven participants completed all three measures. RESULTS: Significant correlations were found between compulsive buying severity and the acquisition dimension of hoarding. Binge eating severity was significantly correlated with all three dimensions of hoarding. Hierarchical regression analysis found that compulsive buying severity was a significant predictor of binge eating severity. However, compulsive buying severity no longer predicted binge eating severity when the dimensions of hoarding were included simultaneously in the model. Clutter was the only subscale of hoarding to predict binge eating severity in step two of the regression analysis. CONCLUSION: Our results suggest that the psychological need to excessively gather and store items may constitute a shared process that is important in understanding behaviors characterized by excessive consumption such as compulsive buying and binge eating.