Nameth Katherine, Brown Theresa, Bullock Kim, Adler Sarah, Riva Giuseppe, Safer Debra, Runfola Cristin
Department of Psychiatry and Behavioral Sciences, 401 Quarry Rd, Stanford University, Stanford, CA 94305, USA.
PGSP-Stanford PsyD Consortium, 1791 Arastradero Rd, Palo Alto, CA 94304, USA.
J Clin Med. 2021 Apr 5;10(7):1511. doi: 10.3390/jcm10071511.
Binge-eating disorder (BED) and bulimia nervosa (BN) have adverse psychological and medical consequences. Innovative interventions, like the integration of virtual reality (VR) with cue-exposure therapy (VR-CET), enhance outcomes for refractory patients compared to cognitive behavior therapy (CBT). Little is known about the feasibility and acceptability of translating VR-CET into real-world settings. To investigate this question, adults previously treated for BED or BN with at least one objective or subjective binge episode/week were recruited from an outpatient university eating disorder clinic to receive up to eight weekly one-hour VR-CET sessions. Eleven of 16 (68.8%) eligible patients were enrolled; nine (82%) completed treatment; and 82% (9/11) provided follow-up data 7.1 (SD = 2.12) months post-treatment. Overall, participant and therapist acceptability of VR-CET was high. Intent-to-treat objective binge episodes (OBEs) decreased significantly from 3.3 to 0.9/week ( < 0.001). Post-treatment OBE 7-day abstinence rate for completers was 56%, with 22% abstinent for 28 days at follow-up. Among participants purging at baseline, episodes decreased from a mean of one to zero/week, with 100% abstinence maintained at follow-up. The adoption of VR-CET into real-world clinic settings appears feasible and acceptable, with a preliminary signal of effectiveness. Findings, including some loss of treatment gains during follow-up may inform future treatment development.
暴饮暴食症（BED）和神经性贪食症（BN）会产生不良的心理和医学后果。与认知行为疗法（CBT）相比，虚拟现实（VR）与线索暴露疗法相结合（VR-CET）等创新干预措施能改善难治性患者的治疗效果。对于将VR-CET应用于现实环境中的可行性和可接受性，我们了解甚少。为了研究这个问题，我们从一所大学的门诊饮食失调诊所招募了此前接受过BED或BN治疗且每周至少有一次客观或主观暴饮暴食发作的成年人，让他们接受为期八周、每周一小时的VR-CET治疗。16名符合条件的患者中有11名（68.8%）入组；9名（82%）完成了治疗；82%（9/11）的患者在治疗后7.1（标准差 = 2.12）个月提供了随访数据。总体而言，参与者和治疗师对VR-CET的接受度很高。意向性治疗的客观暴饮暴食发作次数（OBEs）从每周3.3次显著降至0.9次（<0.001）。完成治疗的患者治疗后OBEs的7天节制率为56%，随访时28天节制率为22%。在基线时有清除行为的参与者中，发作次数从平均每周一次降至零次，随访时保持100%的节制。将VR-CET应用于现实临床环境似乎是可行且可接受的，并有初步的有效性迹象。研究结果，包括随访期间治疗效果的一些丧失，可能为未来的治疗发展提供参考。
