Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstr. 10, Leipzig 04103, Germany.
BMC Psychiatry. 2013 Aug 6;13:207. doi: 10.1186/1471-244X-13-207.
This systematic review evaluates the efficacy of internet-based interventions for the treatment of different eating disorders in adults.
A search for peer reviewed journal articles detailing Randomised Control Trials (RCT) and Controlled Trials (CT) addressing participants with eating disorders aged at least 16 was completed in the electronic databases Web of Science, PsycInfo and PubMed. The quality of the included articles was assessed, results were reviewed and effect sizes and corresponding confidence intervals were calculated.
Eight studies, including a total of N = 609 participants, fulfilled the selection criteria and were included. The majority of treatments applied in these studies were based on CBT principles. Six studies described guided self-help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates. These studies produced significant medium to high effect sizes both within and between the groups after utilisation of guided self-help programs or a self-help book backed up with supportive e-mails. The two remaining studies utilised a specific writing task or e-mail therapy that did not follow a structured treatment program. Here, no significant effects could be found. Treatment dropout rates ranged from 9% to 47.2%. Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies.
Overall, the results support the value of internet-based interventions that use guided self-help to tackle eating disorders, but further research is needed due to the heterogeneity of the studies.
本系统评价评估了基于互联网的干预措施在治疗成年人不同饮食障碍方面的疗效。
在 Web of Science、PsycInfo 和 PubMed 电子数据库中搜索了详细描述针对至少 16 岁饮食障碍患者的随机对照试验 (RCT) 和对照试验 (CT) 的同行评审期刊文章。评估了纳入文章的质量，审查了结果，并计算了效应大小和相应的置信区间。
符合选择标准并纳入的研究共有 8 项，共纳入 N = 609 名参与者。这些研究中应用的大多数治疗方法都基于 CBT 原则。六项研究描述了基于指导的自助干预措施，这些措施在饮食行为和戒断率等主要和次要结果方面显示出显著的症状减轻。这些研究在使用基于指导的自助程序或自助书籍并辅以支持性电子邮件后，在组内和组间均产生了显著的中等到高的效应大小。其余两项研究使用了特定的写作任务或电子邮件治疗，但没有遵循结构化的治疗方案。在这里，没有发现显著的效果。治疗退出率从 9%到 47.2%不等。此外，四项研究发现其他症状（例如抑郁和焦虑）有所减轻，生活质量有所提高。
总的来说，这些结果支持使用基于互联网的干预措施，使用基于指导的自助来解决饮食障碍问题，但由于研究的异质性，需要进一步研究。
