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Guided self‐help versus cognitive‐behavioral group therapy in the treatment of bulimia nervosa
Author(s) -
Bailer Ursula,
de Zwaan Martina,
Leisch Friedrich,
Strnad Alexandra,
LennkhWolfsberg Claudia,
ElGiamal Nadia,
Hornik Kurt,
Kasper Siegfried
Publication year - 2004
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.20003
Subject(s) - bulimia nervosa , binge eating , eating disorders , psychology , psychopathology , beck depression inventory , cognitive behavioral therapy , depression (economics) , vomiting , binge eating disorder , clinical psychology , cognitive therapy , psychiatry , anorexia nervosa , cognition , medicine , anxiety , economics , macroeconomics
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.