ABSTRACT
OBJECTIVE: Technology assisted guided self-help has been proven to be effective in the treatment of bulimia nervosa (BN). The aim of this study was to determine predictors of good long-term outcome as well as drop-out, in order to identify patients for whom these interventions are most suitable. METHODS: One hundred and fifty six patients with BN were assigned to either 7 months internet-based guided self-help (INT-GSH) or to conventional guided bibliotherapy (BIB-GSH), both guided by e-mail support. Evaluations were taken at baseline, after 4, 7, and 18 months. As potential predictors, psychiatric comorbidity, personality features, and eating disorder psychopathology were considered. RESULTS: Higher motivation, lower frequency of binge eating, and lower body dissatisfaction at baseline predicted good outcome after the end of treatment. Lower frequency of binge eating predicted good outcome at long-term follow-up. Factors prediciting drop-out were higher depression and lower self-directedness at baseline. CONCLUSION: Technology assisted self-help can be recommended for patients with a high motivation to change, lower binge-eating frequency and lower depression scores.
Subject(s)
Binge-Eating Disorder/therapy , Bulimia Nervosa/therapy , Bulimia/therapy , Cognitive Behavioral Therapy/methods , Outcome Assessment, Health Care/statistics & numerical data , Self Care/methods , Therapy, Computer-Assisted , Adult , Bibliotherapy , Binge-Eating Disorder/psychology , Body Image , Bulimia/psychology , Bulimia Nervosa/psychology , Depression/psychology , Depression/therapy , Electronic Mail , Female , Humans , Internet , Male , Middle Aged , Motivation , Patient Dropouts , Phenotype , Psychopathology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: This study aims to evaluate the long-term outcome of new technology assisted guided self-help in adolescents with bulimia nervosa (BN). METHOD: One hundred and twenty-six patients with BN (29 adolescents and 97 adults) were randomly allocated to a cognitive behavioural therapy-based self-help program delivered by the Internet or bibliotherapy, both accompanied by e-mail guidance. Outcomes were assessed at baseline, month 4, 7 and 18 including remission rates and eating disorder associated psychopathology. RESULTS: In all, 44% of adolescents vs. 38.7% of adults were in remission at month 7, and 55% of adolescents vs. 62.5% of adults were in remission at follow-up. Objective binge eating and compensatory behaviour improved significantly over time in both groups, with the highest decrease during the first 4 months. A significant decrease over time and no group differences have been found in almost all EDI-2 subscales. CONCLUSIONS: E-mail guided self-help (delivered via the Internet or bibliotherapy) is equally effective for adolescents as for adults with BN, and can be recommended as an initial step of treatment for this younger age group.
