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Internet-based interventions for eating disorders in adults: a systematic review.

Dölemeyer R, Tietjen A, Kersting A, Wagner B - BMC Psychiatry (2013)

Bottom Line: Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates.Here, no significant effects could be found.Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstr. 10, Leipzig 04103, Germany. ruth.doelemeyer@medizin.uni-leipzig.de

ABSTRACT

Background: This systematic review evaluates the efficacy of internet-based interventions for the treatment of different eating disorders in adults.

Method: A search for peer reviewed journal articles detailing Randomised Control Trials (RCT) and Controlled Trials (CT) addressing participants with eating disorders aged at least 16 was completed in the electronic databases Web of Science, PsycInfo and PubMed. The quality of the included articles was assessed, results were reviewed and effect sizes and corresponding confidence intervals were calculated.

Results: Eight studies, including a total of N = 609 participants, fulfilled the selection criteria and were included. The majority of treatments applied in these studies were based on CBT principles. Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates. These studies produced significant medium to high effect sizes both within and between the groups after utilisation of guided self-help programs or a self-help book backed up with supportive e-mails. The two remaining studies utilised a specific writing task or e-mail therapy that did not follow a structured treatment program. Here, no significant effects could be found. Treatment dropout rates ranged from 9% to 47.2%. Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies.

Conclusions: Overall, the results support the value of internet-based interventions that use guided self-help to tackle eating disorders, but further research is needed due to the heterogeneity of the studies.

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Related in: MedlinePlus

Identifying studies for inclusion in systematic review.
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Figure 1: Identifying studies for inclusion in systematic review.

Mentions: The search and selection process for articles is illustrated in Figure 1. A total of 651 articles were identified by the initial search. After removing duplicate articles (n = 191) and irrelevant studies (n = 436), 24 articles were retained for further consideration. Of these, 16 articles were excluded as they addressed prevention of eating disorders or presented data from participants who did not fulfil a diagnosis of an eating disorder (n = 6), they did not use a controlled design (n = 5), they were addressing relapse prevention (n = 1) or they did not use internet-based therapy as the mode of delivery (n = 4). Screening the reference lists from retrieved articles did not lead to the inclusion of any additional relevant literature → Figure 1.


Internet-based interventions for eating disorders in adults: a systematic review.

Dölemeyer R, Tietjen A, Kersting A, Wagner B - BMC Psychiatry (2013)

Identifying studies for inclusion in systematic review.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750530&req=5

Figure 1: Identifying studies for inclusion in systematic review.
Mentions: The search and selection process for articles is illustrated in Figure 1. A total of 651 articles were identified by the initial search. After removing duplicate articles (n = 191) and irrelevant studies (n = 436), 24 articles were retained for further consideration. Of these, 16 articles were excluded as they addressed prevention of eating disorders or presented data from participants who did not fulfil a diagnosis of an eating disorder (n = 6), they did not use a controlled design (n = 5), they were addressing relapse prevention (n = 1) or they did not use internet-based therapy as the mode of delivery (n = 4). Screening the reference lists from retrieved articles did not lead to the inclusion of any additional relevant literature → Figure 1.

Bottom Line: Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates.Here, no significant effects could be found.Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstr. 10, Leipzig 04103, Germany. ruth.doelemeyer@medizin.uni-leipzig.de

ABSTRACT

Background: This systematic review evaluates the efficacy of internet-based interventions for the treatment of different eating disorders in adults.

Method: A search for peer reviewed journal articles detailing Randomised Control Trials (RCT) and Controlled Trials (CT) addressing participants with eating disorders aged at least 16 was completed in the electronic databases Web of Science, PsycInfo and PubMed. The quality of the included articles was assessed, results were reviewed and effect sizes and corresponding confidence intervals were calculated.

Results: Eight studies, including a total of N = 609 participants, fulfilled the selection criteria and were included. The majority of treatments applied in these studies were based on CBT principles. Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates. These studies produced significant medium to high effect sizes both within and between the groups after utilisation of guided self-help programs or a self-help book backed up with supportive e-mails. The two remaining studies utilised a specific writing task or e-mail therapy that did not follow a structured treatment program. Here, no significant effects could be found. Treatment dropout rates ranged from 9% to 47.2%. Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies.

Conclusions: Overall, the results support the value of internet-based interventions that use guided self-help to tackle eating disorders, but further research is needed due to the heterogeneity of the studies.

Show MeSH
Related in: MedlinePlus