Randomised controlled trial of CD–ROM-based cognitive–behavioural self-care for bulimia nervosa

Abstract

Only two-thirds of participants started treatment. Although there were significant group x time interactions for bingeing and vomiting, favouring the CD-ROM group at 3 months and the waiting-list group at 7 months, post hoc group comparisons at 3 and 7 months found no significant differences for bingeing or vomiting. CD-ROM-based delivery of this intervention, without support from a clinician, may not be the best way of exploiting its benefits.

Harnessing the power of technology for the treatment and prevention of eating disorders

“…However, results did not provide evidence for this specific form of stepped care, which might be related to the limited acceptability of unguided self-help. 28 Examples of step-down interventions through technology include the maintenance approaches for anorexia nervosa 23 and bulimia nervosa 20,22 described above.…”

“…There is preliminary evidence that technology-enhanced pure self-help without guidance may not be beneficial to a large proportion of participants. 28 However, it has not been investigated yet how much guidance is needed and sufficient in guided self-help. In general, technology-enhanced programs offer the opportunity to combine standardized and automated components on the one side and those that are more personalized and involve input by a professional on the other side, in order to ultimately serve the maximum number of users in light of limited resources.…”

É hora de investirmos em intervenções comportamentais computadorizadas no Brasil?

“…Duas pesquisas foram conduzidas para avaliar intervenções comportamentais computadorizadas para bulimia nervosa (Schmidt et al, 2008). As intervenções avaliadas tinham como objetivo ser um adjunto ao tratamento tradicional, e desta forma, reduzir o número de consultas durante o tratamento.…”

“…Existem evidências de eficácia destas intervenções para vários tipos de comportamentos e condições de saúde como o uso de álcool e outras drogas (Khadjesari, Murray, Hewitt, Hartley, & Godfrey, 2011;Rooke, Thorsteinsson, Karpin, Copeland, & Allsop, 2010), ansiedade (Cuijpers et al, 2009), depressão (Titov, Andrews, Schwencke, et al, 2010), transtornos alimentares (Schmidt et al, 2008), estresse (Ruwaard, Lange, Bouwman, Broeksteeg, & Schrieken, 2007) e dor (Velleman, Stallard, & Richardson, 2010). Embora existam evidências de eficácia, as intervenções comportamentais computadorizadas ainda carecem de evidências de efetividade (Andersson, Carlbring, & Cuijpers, 2009).…”

E-mental health – a land of unlimited possibilities

“…Much research in the area of e-mental health has focused on interactive online interventions, largely based on cognitive-behavioural approaches, for the treatment and prevention of common mental disorders such as depression and anxiety disorders (Griffiths et al, 2010), substance misuse disorders (Tait & Christensen, 2010) and some forms of eating disorders (Sánchez-Ortiz et al, 2011a;Schmidt et al, 2008), assessing questions of adherence (Donkin et al, 2011), efficacy, level and type of support needed, cost-effectiveness and how to integrate these interventions into stepped care approaches. Less is known about the experience of service users of these interventions, but studies assessing this are also beginning to emerge (Sánchez-Ortiz et al, 2011b).…”