Limits...
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.

Show MeSH

Related in: MedlinePlus

Effect sizes and corresponding confidence intervals for Bingeing, Purging and the EDE-Q Total Score.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3750530&req=5

Figure 2: Effect sizes and corresponding confidence intervals for Bingeing, Purging and the EDE-Q Total Score.

Mentions: Figure 2 shows effect sizes and corresponding confidence intervals for bingeing and purging. Six of the studies assessed bingeing or purging, while in two studies [15,17] these behaviours were not assessed. Medium to large effect sizes from pre- to post-treatment were found in the intervention group for both bingeing and purging episodes, ranging from 0.75 to 1.05 for binge episodes and from 0.41 to 0.77 for purging. When effect sizes were calculated between groups, however, a significant reduction in the number of binge episodes in the intervention group as compared to the control group was only found in two studies [12,16], with moderate effect sizes. In studies that assessed purging behaviour, no significant differences in reduction of purging between groups were found, with one exception. One study [16] found a significant reduction in purging behaviour in the intervention group compared to the control group, with a considerably high effect size of 1.63. Sanchez-Ortiz and colleagues [19] additionally assessed frequency of vomiting and found medium-sized effects within the treatment group, while effects were only small when the two groups were compared. In contrast to this, Fernandez-Aranda et al. [14] assessed frequency of vomiting and reported high effect sizes after comparing the two groups.


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

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

Effect sizes and corresponding confidence intervals for Bingeing, Purging and the EDE-Q Total Score.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Effect sizes and corresponding confidence intervals for Bingeing, Purging and the EDE-Q Total Score.
Mentions: Figure 2 shows effect sizes and corresponding confidence intervals for bingeing and purging. Six of the studies assessed bingeing or purging, while in two studies [15,17] these behaviours were not assessed. Medium to large effect sizes from pre- to post-treatment were found in the intervention group for both bingeing and purging episodes, ranging from 0.75 to 1.05 for binge episodes and from 0.41 to 0.77 for purging. When effect sizes were calculated between groups, however, a significant reduction in the number of binge episodes in the intervention group as compared to the control group was only found in two studies [12,16], with moderate effect sizes. In studies that assessed purging behaviour, no significant differences in reduction of purging between groups were found, with one exception. One study [16] found a significant reduction in purging behaviour in the intervention group compared to the control group, with a considerably high effect size of 1.63. Sanchez-Ortiz and colleagues [19] additionally assessed frequency of vomiting and found medium-sized effects within the treatment group, while effects were only small when the two groups were compared. In contrast to this, Fernandez-Aranda et al. [14] assessed frequency of vomiting and reported high effect sizes after comparing the two groups.

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