PDF(Pubmed)
Abstract：
BACKGROUND: Although effective treatments for bulimic-spectrum eating disorders exist, access is often delayed because of limited therapist availability and lengthy waiting lists. Web-based self-help interventions have the potential to bridge waiting times for face-to-face treatment and overcome existing treatment gaps.
OBJECTIVE: This study aims to assess the effectiveness of a web-based guided self-help intervention (everyBody Plus) for patients with bulimia nervosa, binge eating disorder and other specified feeding and eating disorders who are waiting for out-patient treatment.
METHODS: A randomised controlled trial was conducted in Germany and the UK. A total of 343 patients were randomly assigned to the intervention \'everyBody Plus\' or a waitlist control condition. The primary outcome was the number of weeks after randomisation until a patient achieved a clinically relevant improvement in core symptoms for the first time. Secondary outcomes included eating disorder attitudes and behaviours, and general psychopathology.
RESULTS: At 6- and 12-month follow-up, the probability of being abstinent from core symptoms was significantly larger for the intervention group compared with the control group (hazard ratio: 1.997, 95% CI 1.09-3.65; P = 0.0249). The intervention group also showed larger improvements in eating disorder attitudes and behaviours, general psychopathology, anxiety, depression and quality of life, compared with the control group at most assessment points. Working alliance ratings with the online therapist were high.
CONCLUSIONS: The self-help intervention everyBody Plus, delivered with relatively standardised online guidance, can help bridge treatment gaps for patients with bulimic-spectrum eating disorders, and achieve faster and greater reductions in core symptoms.
OBJECTIVE: This study aims to assess the effectiveness of a web-based guided self-help intervention (everyBody Plus) for patients with bulimia nervosa, binge eating disorder and other specified feeding and eating disorders who are waiting for out-patient treatment.
METHODS: A randomised controlled trial was conducted in Germany and the UK. A total of 343 patients were randomly assigned to the intervention \'everyBody Plus\' or a waitlist control condition. The primary outcome was the number of weeks after randomisation until a patient achieved a clinically relevant improvement in core symptoms for the first time. Secondary outcomes included eating disorder attitudes and behaviours, and general psychopathology.
RESULTS: At 6- and 12-month follow-up, the probability of being abstinent from core symptoms was significantly larger for the intervention group compared with the control group (hazard ratio: 1.997, 95% CI 1.09-3.65; P = 0.0249). The intervention group also showed larger improvements in eating disorder attitudes and behaviours, general psychopathology, anxiety, depression and quality of life, compared with the control group at most assessment points. Working alliance ratings with the online therapist were high.
CONCLUSIONS: The self-help intervention everyBody Plus, delivered with relatively standardised online guidance, can help bridge treatment gaps for patients with bulimic-spectrum eating disorders, and achieve faster and greater reductions in core symptoms.
摘要：
背景：尽管存在针对暴食谱系性进食障碍的有效治疗方法，访问往往是由于有限的治疗师可用性和冗长的等待名单而延迟.基于网络的自助干预有可能缩短面对面治疗的等待时间，并克服现有的治疗差距。
目的：本研究旨在评估基于网络的指导自助干预（everyBodyPlus）对神经性贪食症患者的有效性，正在等待门诊治疗的暴饮暴食症和其他指定的进食和进食障碍。
方法：在德国和英国进行了一项随机对照试验。共有343名患者被随机分配到“everyBodyPlus”干预或等待列表控制条件。主要结果是随机分组后直到患者首次获得核心症状的临床相关改善的周数。次要结果包括饮食失调的态度和行为，和一般精神病理学。
结果：在6个月和12个月的随访中，与对照组相比,干预组患者戒除核心症状的可能性明显更大(风险比:1.997,95%CI1.09-3.65;P=0.0249).干预组的饮食失调态度和行为也有了较大的改善，一般精神病理学，焦虑,抑郁和生活质量，在大多数评估点与对照组比较。与在线治疗师的工作联盟评分很高。
结论：自助干预everyBodyPlus，提供相对标准化的在线指导，可以帮助弥合贪食症患者的治疗差距，并实现更快、更大的核心症状减少。
目的：本研究旨在评估基于网络的指导自助干预（everyBodyPlus）对神经性贪食症患者的有效性，正在等待门诊治疗的暴饮暴食症和其他指定的进食和进食障碍。
方法：在德国和英国进行了一项随机对照试验。共有343名患者被随机分配到“everyBodyPlus”干预或等待列表控制条件。主要结果是随机分组后直到患者首次获得核心症状的临床相关改善的周数。次要结果包括饮食失调的态度和行为，和一般精神病理学。
结果：在6个月和12个月的随访中，与对照组相比,干预组患者戒除核心症状的可能性明显更大(风险比:1.997,95%CI1.09-3.65;P=0.0249).干预组的饮食失调态度和行为也有了较大的改善，一般精神病理学，焦虑,抑郁和生活质量，在大多数评估点与对照组比较。与在线治疗师的工作联盟评分很高。
结论：自助干预everyBodyPlus，提供相对标准化的在线指导，可以帮助弥合贪食症患者的治疗差距，并实现更快、更大的核心症状减少。
