Leeds Institute of Health Sciences, University of Leeds, UK.
Behav Res Ther. 2011 Jan;49(1):25-31. doi: 10.1016/j.brat.2010.10.007. Epub 2010 Nov 2.
Treatment guidelines recommend evidence-based guided self-help (GSH) as the first stage of treatment for bulimia nervosa and binge eating disorder. The current randomised control trial evaluated a cognitive behavioural therapy-based GSH pack, 'Working to Overcome Eating Difficulties,' delivered by trained mental health professionals in 6 sessions over 3 months. It was congruent with the transdiagnostic approach and so was intended as suitable for all disordered eating, except severe anorexia nervosa. Eighty one clients were randomly allocated to either a GSH or waiting list condition. Eating disorder psychopathology (EDE-Q), key behavioural features and global distress (CORE) were measured at pre- and post-intervention, and 3- and 6-month follow-up. Results showed significant improvements in eating disorder psychopathology, laxative abuse, exercise behaviours, and global distress, with the GSH condition being superior to the waiting list on all outcomes. Treatment gains were maintained at 3 and 6 months. This study adds to the evidence supporting GSH for disordered eating, including EDNOS. However, further work is needed to establish the factors that contribute to observed therapeutic improvements and determine for whom GSH is most suitable.
治疗指南建议将基于证据的自助指导（GSH）作为治疗神经性贪食症和暴食障碍的第一阶段。目前的随机对照试验评估了一种基于认知行为疗法的 GSH 包，名为“努力克服饮食困难”，由经过培训的心理健康专业人员在 3 个月内分 6 次进行。它与跨诊断方法一致，因此适用于所有饮食障碍，除了严重的神经性厌食症。81 名患者被随机分配到 GSH 或候补名单条件。在干预前、干预后以及 3 个月和 6 个月的随访中，测量了饮食障碍心理病理学（EDE-Q）、关键行为特征和总体困扰（CORE）。结果表明，在饮食障碍心理病理学、泻药滥用、运动行为和总体困扰方面有显著改善，GSH 组在所有结果上均优于候补名单组。治疗效果在 3 个月和 6 个月时保持稳定。这项研究增加了支持 GSH 治疗饮食障碍的证据，包括 EDNOS。然而，需要进一步的工作来确定导致观察到的治疗改善的因素，并确定 GSH 最适合哪些人。
