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Guided self‐help versus cognitive‐behavioral group therapy in the treatment of bulimia nervosa

2004; Wiley; Volume: 35; Issue: 4 Linguagem: Inglês

10.1002/eat.20003

1098-108X

Ursula F. Bailer, Martina de Zwaan, Friedrich Leisch, A. Strnad, Claudia Lennkh‐Wolfsberg, Nadia El‐Giamal, Kurt Hornik, Siegfried Kasper,

Impact of Technology on Adolescents

Abstract Objective The aim of the current study was to evaluate whether guided self‐help was effective in the short and long term in the treatment of bulimia nervosa. Method Eighty‐one patients with bulimia nervosa were randomly assigned to either a self‐help manual with a maximum of 18 short weekly visits (guided self‐help) or to 18 weekly 1.5‐h sessions of cognitive‐behavioral group therapy (CBT). The primary outcome variables were monthly frequencies of self‐reported binge eating and vomiting episodes. Secondary outcome variables were eating disorder‐related psychopathology (assessed with the Eating Disorders Inventory [EDI]) and depression (assessed by the Beck Depression Inventory [BDI]). Patients were followed up 1 year after the end of treatment. Results A mixed‐effects linear regression analysis indicated that subjects in both treatment conditions showed a significant decrease over time in binge eating and vomiting frequencies, in the scores of the EDI subscales, and in the BDI. Both treatment modalities led to a sustained improvement at follow‐up. A separate analysis of the completer sample showed significantly higher remission rates in the self‐help condition (74%) compared with the CBT condition (44%) at follow‐up. Conclusions Guided self‐help incorporating the use of a self‐help manual offers an approach that can be effective in the short and long‐term treatment of bulimia nervosa. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 522–537, 2004.