Pittock Alexandra, Hodges Laura, Lawrie Stephen M
Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK.
BMC Res Notes. 2018 Oct 22;11(1):748. doi: 10.1186/s13104-018-3843-2.
This review looked at internet-delivered cognitive behavioural therapy (iCBT) as a possible treatment for patients with bulimic symptoms. CBT has been established as an effective treatment; however, waiting lists lead to delayed initiation of treatment. iCBT is a possible delivery method to combat this. Medline, EMBASE and PsycInfo were searched for controlled trials using iCBT as a treatment for patients with bulimia nervosa (BN), subthreshold BN or 'eating disorders not otherwise specified' with bulimic characteristics (EDNOS-BN). The literature search returned 482 papers. 5 met the review criteria and were compared in characteristics, methodological quality and outcomes. Outcomes were analysed by calculation of effect sizes; iCBT was evaluated on reduction in binge eating and purging post treatment and at follow-up.
Participants were mostly female with an average age range of 23.7-31 years. 4 studies demonstrated good methodological quality. 1 did not report all of the outcome data, increasing the likelihood of bias. Only 1 study showed widespread benefit over waiting list controls. iCBT was shown to reduce behaviours but was not found to be superior to bibliotherapy or waiting list. Further large-scale studies are required to make conclusive recommendations.
本综述探讨了互联网认知行为疗法（iCBT）作为治疗贪食症状患者的一种可能方法。认知行为疗法已被确立为一种有效的治疗方法；然而，候诊名单导致治疗开始延迟。iCBT是应对这一问题的一种可能的治疗方式。检索了Medline、EMBASE和PsycInfo数据库，查找使用iCBT治疗神经性贪食症（BN）、亚阈值BN或具有贪食特征的“未另行规定的进食障碍”（EDNOS-BN）患者的对照试验。文献检索共得到482篇论文。5篇符合综述标准，并在特征、方法学质量和结果方面进行了比较。通过计算效应量来分析结果；对iCBT在治疗后及随访时减少暴饮暴食和清除行为方面进行了评估。
参与者大多为女性，平均年龄在23.7 - 31岁之间。4项研究显示出良好的方法学质量。1项研究未报告所有结果数据，增加了偏倚的可能性。只有1项研究表明，与候诊名单对照组相比，iCBT有广泛的益处。iCBT被证明可以减少相关行为，但并未发现其优于自助书籍疗法或候诊名单。需要进一步开展大规模研究以得出确凿的建议。
