A randomised controlled trial of clinician supported vs self-help delivery of online cognitive behaviour therapy for Bulimia Nervosa.

Humans Bulimia Nervosa / therapy Cognitive Behavioral Therapy / methods Health Behavior Treatment Outcome
Bulimia Clinician-supported self-help treatment Cognitive behavioural therapy Digital treatment Disordered eating Eating disorders Guided self-help Internet OSFED Online treatment Randomised controlled trial Self-help treatment

Journal

Psychiatry research
ISSN: 1872-7123
Titre abrégé: Psychiatry Res
Pays: Ireland
ID NLM: 7911385

Informations de publication

Date de publication:
11 2023
Historique:
received: 12 08 2023
revised: 02 10 2023
accepted: 06 10 2023
medline: 3 11 2023
pubmed: 16 10 2023
entrez: 16 10 2023
Statut: ppublish

Résumé

High dropout rates and poor adherence associated with digital interventions have prompted research into modifications of these treatments to improve engagement and completion rates. This trial aimed to investigate the added benefit of clinician support when paired alongside a ten-session, online cognitive behaviour therapy (CBT) self-help intervention for bulimia nervosa (BN). As part of a three-arm, phase II randomised controlled trial, 114 participants (16 years or over) with full or subthreshold BN were randomly assigned to complete the intervention in a self-help mode (with administrative researcher contact; n = 38), with adjunct clinician support (weekly 30-minute videoconferencing sessions; n = 37), or a no-treatment waitlist control (WLC; n = 39). Baseline to post-treatment (12-weeks) decreases in objective binge episode frequency were significantly greater for clinician-supported participants as compared to WLC, but not for self-help when compared to WLC. However, due to continued improvements for self-help across follow-up (24-weeks), both arms outperformed WLC when analysed as an overall rate of change across three timepoints. Clinician-supported participants outperformed self-help in regards to laxative use and dietary restraint. Our results demonstrate that good clinical outcomes can be achieved with a relatively brief online CBT-based program even in the absence of structured clinical support, indicating a possible overreliance upon clinician support as a primary adherence-facilitating mechanism.

Identifiants

DOI: 10.1016/j.psychres.2023.115534 PMID: 37844353
pubmed: 37844353
pii: S0165-1781(23)00484-5
doi: 10.1016/j.psychres.2023.115534
pii:
doi:

Types de publication

Randomized Controlled Trial Clinical Trial, Phase II Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

115534

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Sarah Barakat (S)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia; School of Psychology, University of Sydney, Sydney, NSW, Australia. Electronic address: sarah.barakat@sydney.edu.au.

Amy L Burton (AL)

School of Psychology, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Graduate School of Health, University of Technology Sydney, Sydney NSW, Australia.

Michelle Cunich (M)

Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, NSW, Australia; Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), University of Sydney, Sydney, NSW, Australia; Co-Lead, Implementation and Policy, Cardiovascular Initiative, University of Sydney, Camperdown, NSW, Australia.

Phillipa Hay (P)

Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia; Mental Health Services South Western Sydney Local Health District, Campbelltown, NSW, Australia.

Jessica L Hazelton (JL)

School of Psychology, University of Sydney, Sydney, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.

Marcellinus Kim (M)

Sydney Local Health District Mental Health Services, Royal Prince Alfred Hospital, Sydney, Australia.

Sharyn Lymer (S)

Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), University of Sydney, Sydney, NSW, Australia.

Sloane Madden (S)

Department of Psychological Medicine, Sydney Children's Hospital Network, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

Danielle Maloney (D)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia.

Jane Miskovic-Wheatley (J)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia.

Daniel Rogers (D)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia.

Janice Russell (J)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia; Sydney Local Health District Mental Health Services, Royal Prince Alfred Hospital, Sydney, Australia.

Morgan Sidari (M)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia; Queensland Eating Disorder Service, Metro North Hospital and Health, Brisbane, QLD, Australia.

Stephen Touyz (S)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia.

Sarah Maguire (S)

InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney and Sydney Local Health District, Sydney, NSW 2006, Australia.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › A randomised controlled trial of clinician...
questionsmedicales.fr › Troubles mentaux › Troubles de l'alimentation › Boulimie nerveuse › A randomised controlled trial of clinician...
questionsmedicales.fr › Disciplines et activités comportementales › Psychothérapie › Thérapie comportementale › Thérapie cognitive › A randomised controlled trial of clinician...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Comportement › Comportement en matière de santé › A randomised controlled trial of clinician...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › A randomised controlled trial of clinician...