Internet-based relapse prevention for anorexia nervosa: nine- month follow-up

Abstract

BackgroundTo study the longer term effects of an internet-based CBT intervention for relapse prevention (RP) in anorexia nervosa.Methods210 women randomized to the RP intervention group (full and partial completers) or the control group were assessed for eating and general psychopathology. Multiple regression analysis identified predictors of favorable course concerning Body Mass Index (BMI). Logistic regression analysis identified predictors of adherence to the RP program.ResultsMost variables assessed showed more improvement for the RP than for the control group. However, only some scales reached statistical significance (bulimic behavior and menstrual function, assessed by expert interviewers blind to treatment condition). Very good results (BMI) were seen for the subgroup of “full completers” who participated in all nine monthly RP internet-based intervention sessions. “Partial completers” and controls (the latter non-significantly) underwent more weeks of inpatient treatment during the study period than “full completers”, indicating better health and less need for additional treatment among the “full completers”. Main long-term predictors for favorable course were adherence to RP, more spontaneity, and more ineffectiveness. Main predictors of good adherence to RP were remission from lifetime mood and lifetime anxiety disorder, a shorter duration of eating disorder, and additional inpatient treatment during RP.ConclusionsConsidering the high chronicity of AN, internet-based relapse prevention following intensive treatment appears to be promising.

E-therapy in the treatment and prevention of eating disorders: A systematic review and meta-analysis

“…A single study, published in two papers, investigated an online CBT-based relapse prevention program, compared with treatment-as-usual, for women with anorexia nervosa or subthreshold anorexia nervosa who had been recently discharged from hospital ( Fichter, Quadflieg, & Lindner, 2013; Fichter et al., 2012 ). The program was associated with small improvements in clinician-rated bulimia, and self- and clinician-rated global eating disorder psychopathology at the end of the intervention, although for clinician-rated global eating disorder psychopathology, the estimate was imprecise.…”

Drivers and Barriers to Acceptance of Web-Based Aftercare of Patients in Inpatient Routine Care: A Cross-Sectional Survey

“…Whereas recent studies point to the acceptance of eHealth records and computer-based diagnostic systems in inpatient treatment [28,29], preliminary evidence on some Web-based aftercare projects in German rehabilitation shows fluctuating uptake rates between 21% and 62% [30,12]. Multimedia Appendix 1 compares acceptance ratings (eg, uptake, adherence) of exemplary Web-based aftercare interventions including guided self-help [11], blended [31], mobile-based [12,32], and chat- or education based [33-36] interventions. The results of Pfaudler et al [33] and Küffner [35] indicate organizational and technical problems as pivotal barriers to adoption by inpatients.…”

Carers' Assessment, Skills and Information Sharing (CASIS) Trial: A Qualitative Study of the Experiential Perspective of Caregivers and Patients

“…It is also interesting that many patients reported that the connection with the research team was of benefit to them. This suggests that an intervention for patients bridging this hospital to home period may be of value, such as the relapse prevention programme used in a recent German study (Fichter, Quadflieg, & Lindner, 2013).…”