■暴饮暴食症(BED)是最常见的饮食病症之一,并造成严重的情绪和身体困扰,然而,医疗保健资源不足限制了获得专门治疗的机会。基于网络的自助干预措施成为一种有前途的解决方案,提供更方便的护理。
■研究基于网络的认知行为自助干预对BED患者的有效性。
■这个双臂,2021年1月15日至2022年8月3日在德国和其他德语国家进行的平行组随机临床试验纳入了符合BED诊断标准的18~65岁患者(根据《精神障碍诊断和统计手册[第五版]).根据我们的统计分析计划,数据分析发生在2023年1月27日至9月4日之间。
■参与者被随机分配到基于网络的自助干预或等待列表控制条件。
■主要结果是从基线到治疗后客观暴食发作的变化。次要结果包括全球饮食病理学,临床损害,工作能力,幸福,精神病理学合并症,自尊,和情绪调节。
■总共筛查了1602名患者,其中154人(平均年龄,35.93[10.59]岁;148名女性[96.10%])符合BED标准,并被随机分配(干预组和对照组各77名)。基于网络的干预导致暴饮暴食事件的显着改善(Cohend,-0.79[95%CI,-1.17至-0.42];P<.001),全球饮食精神病理学(科恩d,-0.71[95%CI,-1.07至-0.35];P<.001),每周暴饮暴食(科恩d,-0.49[95%CI,-0.74至-0.24];P<.001),临床损害(科恩d,-0.75[95%CI,-1.13至-0.37];P<.001),福祉(科恩d,0.38[95%CI,0.01至0.75];P=0.047),抑郁症(科恩d,-0.49[95%CI,-0.86至-0.12];P=0.01),焦虑(科恩d,-0.37[95%CI,-0.67至-0.07];P=.02),自尊(科恩d,0.36[95%CI,0.13至0.59];P=.003),和情绪调节(困难:科恩d,-0.36[95%CI,-0.65至-0.07];P=0.01,曲目:科恩d,0.52[95%CI,0.19至0.84];P=.003)。
■在这项针对BED患者的基于网络的自助干预的随机临床试验中,这些发现证实了它在减少暴饮暴食事件和改善各种心理健康结果方面的有效性,突出了一个可扩展的解决方案,以弥合这种情况的治疗差距。
■ClinicalTrials.gov标识符:NCT04876183。
UNASSIGNED: Binge eating disorder (BED) is one of the most frequent eating pathologies and imposes substantial emotional and physical distress, yet insufficient health care resources limit access to specialized treatment. Web-based self-help interventions emerge as a promising solution, offering more accessible care.
UNASSIGNED: To examine the effectiveness of a web-based cognitive behavioral self-help intervention for individuals with BED.
UNASSIGNED: This 2-arm, parallel-group randomized clinical
trial conducted from January 15, 2021, to August 3, 2022, in Germany and other German-speaking countries enrolled patients aged 18 to 65 years who met the diagnostic criteria for BED (according to the Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]). Data analysis occurred between January 27 and September 4, 2023, following our statistical analysis plan.
UNASSIGNED: Participants were randomized to a web-based self-help intervention or a waiting-list control condition.
UNASSIGNED: The primary outcome was a change in objective binge eating episodes from baseline to after treatment. Secondary outcomes included global eating pathology, clinical impairment, work capacity, well-being, comorbid psychopathology, self-esteem, and emotion regulation.
UNASSIGNED: A total of 1602 patients were screened, of whom 154 (mean [SD] age, 35.93 [10.59] years; 148 female [96.10%]) fulfilled the criteria for BED and were randomized (77 each to the intervention and control groups). The web-based intervention led to significant improvements in binge eating episodes (Cohen d, -0.79 [95% CI, -1.17 to -0.42]; P < .001), global eating psychopathology (Cohen d, -0.71 [95% CI, -1.07 to -0.35]; P < .001), weekly binge eating (Cohen d, -0.49 [95% CI, -0.74 to -0.24]; P < .001), clinical impairment (Cohen d, -0.75 [95% CI, -1.13 to -0.37]; P < .001), well-being (Cohen d, 0.38 [95% CI, 0.01 to 0.75]; P = .047), depression (Cohen d, -0.49 [95% CI, -0.86 to -0.12]; P = .01), anxiety (Cohen d, -0.37 [95% CI, -0.67 to -0.07]; P = .02), self-esteem (Cohen d, 0.36 [95% CI, 0.13 to 0.59]; P = .003), and emotion regulation (difficulties: Cohen d, -0.36 [95% CI, -0.65 to -0.07]; P = .01 and repertoire: Cohen d, 0.52 [95% CI, 0.19 to 0.84]; P = .003).
UNASSIGNED: In this randomized clinical
trial of a web-based self-help intervention for patients with BED, the findings confirmed its effectiveness in reducing binge eating episodes and improving various mental health outcomes, highlighting a scalable solution to bridge the treatment gap for this condition.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT04876183.