Psychiatric comorbidity is common in binge-eating disorder (BED) but effects on treatment outcomes are unknown. The current study aimed to determine whether psychiatric comorbidity predicted or moderated BED treatment outcomes.

In total, 636 adults with BED in randomized-controlled trials (RCTs) were assessed prior, throughout, and posttreatment by doctoral research-clinicians using reliably-administered semi-structured interviews, self-report measures, and measured weight. Data were aggregated from RCTs testing cognitive-behavioral therapy, behavioral weight loss, multi-modal (combined pharmacological plus cognitive-behavioral/behavioral), and/or control conditions. Intent-to-treat analyses (all available data) tested comorbidity (mood, anxiety, ‘any disorder’ separately) as predictors and moderators of outcomes. Mixed-effects models tested comorbidity effects on binge-eating frequency, global eating-disorder psychopathology, and weight. Generalized estimating equation models tested binge-eating remission (zero binge-eating episodes during the past month; missing data imputed as failure).

Overall, 41% of patients had current psychiatric comorbidity; 22% had mood and 23% had anxiety disorders. Psychiatric comorbidity did not significantly moderate the outcomes of specific treatments. Psychiatric comorbidity predicted worse eating-disorder psychopathology and higher binge-eating frequency across all treatments and timepoints. Patients with mood comorbidity were significantly less likely to remit than those without mood disorders (30% v. 41%). Psychiatric comorbidity neither predicted nor moderated weight loss.

Psychiatric comorbidity was associated with more severe BED psychopathology throughout treatment but did not moderate outcomes. Findings highlight the need to improve treatments for BED with psychiatric comorbidities but challenge perspectives that combining existing psychological and pharmacological interventions is warranted. Treatment research must identify more effective interventions for BED overall and for patients with comorbidities.

精神疾病在暴食症 (BED) 中很常见，但对治疗结果的影响尚不清楚。目前的研究旨在确定精神病合并症是否可以预测或调节 BED 治疗结果。

在随机对照试验 (RCT) 中，共有 636 名患有 BED 的成年人在治疗前、治疗期间和治疗后由博士研究-临床医生使用可靠的半结构化访谈、自我报告措施和测量体重进行了评估。数据是从测试认知行为疗法、行为减肥、多模式（联合药理学加认知行为/行为）和/或控制条件的随机对照试验中汇总的。意向治疗分析（所有可用数据）分别测试合并症（情绪、焦虑、“任何疾病”）作为结果的预测因子和调节因子。混合效应模型测试了合并症对暴食频率、全球饮食失调精神病理学和体重的影响。广义估计方程模型测试了暴食缓解情况（过去一个月暴食次数为零；

总体而言，41% 的患者目前有精神疾病；22% 的人有情绪，23% 的人有焦虑症。精神疾病并没有显着缓和特定治疗的结果。在所有治疗和时间点上，精神病合并症预示着更严重的进食障碍精神病理学和更高的暴食频率。与没有情绪障碍的患者相比，有情绪合并症的患者缓解的可能性要小得多（30%对41%）。精神病合并症既不能预测也不能调节体重减轻。

在整个治疗过程中，精神病合并症与更严重的 BED 精神病理学有关，但不会影响结果。研究结果强调了改善 BED 与精神疾病合并症治疗的必要性，但挑战了将现有的心理和药物干预相结合的观点。治疗研究必须确定更有效的 BED 整体干预措施和合并症患者。