■尽管存在有效的治疗方法,许多神经性贪食症(BN)患者未接受循证治疗.将数字干预措施纳入常规护理可能会影响更多患者,并减轻BN的临床负担。
■评估基于网络的认知行为自助干预对BN患者的有效性。
■在2021年2月2日至2022年7月9日之间在德国进行了2组随机临床试验,没有随访。符合BN诊断标准的年龄在18至65岁之间的参与者通过自我转诊在线注册。数据分析于2022年10月24日至2023年12月23日进行。
■将包括12个每周模块的基于网络的认知行为自助干预与仅获得常规护理的等待列表对照组进行比较。
■主要结果是基线和治疗后之间的贪食发作次数的变化。次要结果包括全球饮食失调症状的变化,临床损害,幸福,工作能力,合并症,自尊,和情绪调节辅之以每周措施和生态瞬时评估。进行了意向治疗分析。
■参与者(N=154;平均[SD]年龄,29.6[8.6]岁;149[96.8%]女性)接受基于网络的干预后,与对照组相比,暴食发作的减少幅度更大(Cohend=-0.48;95%CI,-0.75至-0.20;P<.001),代表暴饮暴食发作的显着变化(科恩d=-0.61;95%CI,-0.89至-0.33;P<.001),但不是代偿行为(科恩d=-0.25;95%CI,-0.51至0.02;P=.21)。干预措施在改善总体进食障碍症状(Cohend=-0.61;95%CI,-0.89至-0.32;P<.001)和临床损害(Cohend=-0.62;95%CI,-0.92至-0.33;P<.001)方面表现优异。对幸福感(科恩d=-0.08;95%CI,-0.37至0.22;P>.99)和工作能力(科恩d=-0.01;95%CI,-0.68至0.66;P=.99)没有发现显著影响。探索性分析表明,自尊和情绪调节困难发生了显著变化,但不是共病症状。
■在这项随机临床试验中,基于网络的认知行为自助干预可有效降低BN患者的进食障碍症状和疾病相关负担,强调数字干预对现有治疗的补充潜力。
■ClinicalTrials.gov标识符:NCT04876196。
UNASSIGNED: Despite the existence of effective treatments, many individuals with bulimia nervosa (BN) do not receive evidence-based therapies. Integrating digital interventions into routine care might reach more patients and reduce the clinical burden of BN.
UNASSIGNED: To evaluate the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BN.
UNASSIGNED: A 2-group randomized clinical
trial without follow-up was conducted between February 2, 2021, and July 9, 2022, in Germany. Participants aged between 18 and 65 years who met the diagnostic criteria for BN were enrolled online via self-referral. Data analyses were conducted from October 24, 2022, to December 23, 2023.
UNASSIGNED: A web-based cognitive behavioral self-help intervention including 12 weekly modules was compared with a waiting-list control group only having access to routine care.
UNASSIGNED: The primary outcome was the change in the number of bulimic episodes between baseline and posttreatment. Secondary outcomes included changes in global eating disorder symptoms, clinical impairment, well-being, work capacity, comorbid symptoms, self-esteem, and emotion regulation complemented by weekly measures and ecological momentary assessment. Intention-to-treat analyses were performed.
UNASSIGNED: Participants (N = 154; mean [SD] age, 29.6 [8.6] years; 149 [96.8%] female) receiving the web-based intervention demonstrated a significantly greater decrease in bulimic episodes compared with the control group (Cohen d = -0.48; 95% CI, -0.75 to -0.20; P < .001), representing a significant change in binge-eating episodes (Cohen d = -0.61; 95% CI, -0.89 to -0.33; P < .001), but not in compensatory behaviors (Cohen d = -0.25; 95% CI, -0.51 to 0.02; P = .21). The intervention was superior in improving global eating disorder symptoms (Cohen d = -0.61; 95% CI, -0.89 to -0.32; P < .001) and clinical impairment (Cohen d = -0.62; 95% CI, -0.92 to -0.33; P < .001). No significant effects were found for well-being (Cohen d = -0.08; 95% CI, -0.37 to 0.22; P > .99) and work capacity (Cohen d = -0.01; 95% CI, -0.68 to 0.66; P = .99). Exploratory analyses indicated significant changes in self-esteem and emotion regulation difficulties, but not in comorbid symptoms.
UNASSIGNED: In this randomized clinical
trial, a web-based cognitive behavioral self-help intervention effectively decreased eating disorder symptoms and illness-related burden in individuals with BN, underlining the potential of digital interventions to complement established treatments.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT04876196.