Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
New York State Psychiatric Institute, New York, New York, USA.
Int J Eat Disord. 2020 May;53(5):497-509. doi: 10.1002/eat.23258. Epub 2020 Mar 11.
Peer mentorship has been shown to be helpful for other mental health conditions, but it has been understudied for patients with eating disorders. The goal of the present study was to evaluate the feasibility and efficacy of peer mentorship for individuals with eating disorders by conducting a randomized controlled trial (RCT).
Parallel three-arm pilot RCT with 1:1:1 allocation to peer mentorship, social support mentorship (active comparison intervention), and waiting list.
Sixty outpatients with anorexia nervosa (AN), bulimia nervosa (BN), or binge-eating disorder (BED) were randomly assigned to a condition. Outcome measures, including eating disorder symptoms and general psychopathology, were completed at baseline, mid-, and postintervention.
Session attendance and acceptability ratings were higher in peer mentorship than social support mentorship. More participants in social support mentorship (39%) dropped out compared to peer mentorship (5%). In intent-to-treat analysis, peer mentorship showed greater reductions in body dissatisfaction and anxiety compared with both control groups. Compared with social support mentorship, peer mentorship had greater reductions in depression. Compared with waiting list, peer mentorship had greater reduction in binge eating days/week in patients with BN/BED and restriction days/week in patients with AN. Peer mentorship did not impact body mass index or reentry into higher level of care.
This pilot RCT provides preliminary evidence that peer mentorship is effective for some cognitive and behavioral symptoms of eating disorders as an adjunct to outpatient treatment. Additional studies are needed to evaluate the efficacy of peer mentorship in absence of treatment.
同伴指导已被证明对其他心理健康状况有帮助，但针对饮食失调患者的研究却很少。本研究的目的是通过开展随机对照试验（RCT）来评估同伴指导对饮食失调患者的可行性和疗效。
采用 1:1:1 随机分组的平行三臂 RCT，分别为同伴指导、社会支持指导（活性对照干预）和等待名单组。
60 名神经性厌食症（AN）、神经性贪食症（BN）或暴食障碍（BED）的门诊患者被随机分配到一个条件中。在基线、中期和干预后完成了包括饮食障碍症状和一般精神病理学在内的结局测量。
同伴指导的出席率和可接受性评分高于社会支持指导。与同伴指导相比，社会支持指导组（39%）有更多的参与者退出。意向治疗分析显示，与对照组相比，同伴指导在身体不满和焦虑方面的改善更为显著。与社会支持指导相比，同伴指导在抑郁方面的改善更为显著。与等待名单相比，在 BN/BED 患者中，同伴指导减少了暴食天数/周，在 AN 患者中，同伴指导减少了限制天数/周。同伴指导对体重指数或重新进入更高水平的治疗没有影响。
这项初步 RCT 提供了初步证据，表明同伴指导作为门诊治疗的辅助手段，对饮食失调的某些认知和行为症状有效。需要进一步的研究来评估在没有治疗的情况下同伴指导的疗效。
