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暴饮暴食症治疗上线——基于互联网的暴饮暴食症治疗的可行性、可用性及治疗效果:一项三臂随机对照试验的研究方案,包括即时治疗组、等待名单组和安慰剂对照组。

Binge-eating disorder treatment goes online - feasibility, usability, and treatment outcome of an Internet-based treatment for binge-eating disorder: study protocol for a three-arm randomized controlled trial including an immediate treatment, a waitlist, and a placebo control group.

作者信息

Munsch Simone, Wyssen Andrea, Vanhulst Pierre, Lalanne Denis, Steinemann Sharon T, Tuch Alexandre

机构信息

Department of Clinical Psychology and Psychotherapy, University of Fribourg, Rue de Faucigny 2, 1700, Fribourg, Switzerland.

Human-IST Institute, University of Fribourg, Boulevard de Perolles 90, 1700, Fribourg, Switzerland.

出版信息

Trials. 2019 Feb 13;20(1):128. doi: 10.1186/s13063-019-3192-z.

Abstract

BACKGROUND

Binge-eating disorder (BED) is characterized by recurrent episodes of loss of control over eating and is related to a higher prevalence of other mental disorders and somatic consequences associated with overweight and obesity. In community-based samples, 2-4% of women and 1-3% men are diagnosed with BED. Psychotherapeutic interventions focusing on maintenance factors of disturbed eating behavior have proven to be effective. However, treatment access is limited for a considerable number of patients with BED. A lack of specialized institutions and treatment resources, but also long distances to treatment facilities for people living in remote or rural areas are often causes of insufficient care. Internet-based guided self-help (GSH) programs have the potential to fill this gap.

METHODS

This project aims to develop and evaluate an Internet-based treatment for BED derived from an evidence-based manualized cognitive behavioral therapy (CBT). The primary goal is to test feasibility and suitability of the Internet-based program and to evaluate the treatment outcome in comparison to a pure and a placebo-inspired waitlist control group (i.e. reduction of binge-eating episodes and eating disorder pathology as primary outcome variables). In total, 60 women and men aged 18-70 years with a BED diagnosis will be recruited. The Internet-based GSH treatment comprises eight sessions followed by three booster sessions. The placebo-inspired waitlist control group receives weekly messages containing information increasing positive expectations regarding the treatment effects during the four-week waiting period. The pure waitlist control group receives weekly messages simply asking patients to fill in a short questionnaire.

DISCUSSION

The access to evidence-based treatments for BED might be made easier using an Internet-based GSH approach. The present study protocol presents a randomized controlled trial. As well as evaluating the suitability and efficacy of the Internet-based GSH treatment, there will also be a prelimarily investigation on the influence of positive expectations (placebo) for a therapeutic intervention on core symptoms.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00012355 . Registered on 14 September 2017.

摘要

背景

暴饮暴食症(BED)的特征是反复出现饮食失控的发作,并且与其他精神障碍的较高患病率以及与超重和肥胖相关的躯体后果有关。在基于社区的样本中,2%-4%的女性和1%-3%的男性被诊断为暴饮暴食症。专注于紊乱饮食行为维持因素的心理治疗干预已被证明是有效的。然而,相当多的暴饮暴食症患者获得治疗的机会有限。缺乏专门机构和治疗资源,以及居住在偏远或农村地区的人们前往治疗机构路途遥远,常常导致护理不足。基于互联网的引导式自助(GSH)项目有潜力填补这一空白。

方法

本项目旨在开发和评估一种基于互联网的暴饮暴食症治疗方法,该方法源自循证手册化认知行为疗法(CBT)。主要目标是测试基于互联网的项目的可行性和适用性,并与纯等待列表对照组和安慰剂激发等待列表对照组相比评估治疗结果(即减少暴饮暴食发作次数和饮食失调病理作为主要结局变量)。总共将招募60名年龄在18至70岁之间、被诊断为暴饮暴食症的男性和女性。基于互联网的GSH治疗包括八个疗程,随后是三个强化疗程。安慰剂激发等待列表对照组在四周等待期内每周收到包含增强对治疗效果积极期望信息的消息。纯等待列表对照组每周收到仅要求患者填写简短问卷的消息。

讨论

使用基于互联网的GSH方法可能会使暴饮暴食症患者更容易获得循证治疗。本研究方案提出了一项随机对照试验。除了评估基于互联网的GSH治疗的适用性和疗效外,还将对治疗干预的积极期望(安慰剂)对核心症状的影响进行初步调查。试验注册:德国临床试验注册中心,DRKS00012355。于2017年9月14日注册。

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