Linnet Jakob, Jensen Esben Skov, Runge Eik, Hansen Marina Bohn, Hertz Søren Peter Thygesen, Mathiasen Kim, Lichtenstein Mia Beck
Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Denmark.
Clinic on Gambling- and Binge Eating Disorder, Department of Occupational and Environmental Medicine, Odense University Hospital, Denmark.
Internet Interv. 2022 Apr 13;28:100538. doi: 10.1016/j.invent.2022.100538. eCollection 2022 Apr.
Some evidence suggests that in internet-based cognitive behavioral therapy (iCBT) the likelihood of adherence is increased when patients write longer messages to the therapist in the program. This association has not previously been investigated in iCBT for Binge Eating Disorder (BED).
In this study, we hypothesized that the number of words written by patients with mild to moderate BED was associated with increased likelihood of treatment completion in a text-based iCBT program.
We compared 143 BED patients (92 completers and 51 non-completers) on the number of messages and words written to their therapist during the treatment.
Completers wrote significantly more words per message (words/message) than non-completers. The results remained significant after controlling for gender, age, educational level, marital status, children, source of income and intake measures of BED, BMI and depression symptoms (Wald = 14.48, < .001). The odds ratio of completion increased by 1.5% for each additional word patients wrote per message (OR = 1.015). The model showed a 72.4% classification accuracy, and an optimal cut-off point of 68.99 words/message for differentiating completers and non-completers. The model accurately identified 80.9% of completers (sensitivity) and 54.9% of non-completers (specificity).
The number of words/message patients write may have important implications for ascertaining likelihood of adherence and improving adherence rates. From a clinical perspective, therapists should encourage patients to use the option of writing messages to the therapist. Words/message may prove to be a transdiagnostic predictor of treatment adherence in text based iCBT.
一些证据表明，在基于互联网的认知行为疗法（iCBT）中，当患者在程序中给治疗师写更长的信息时，坚持治疗的可能性会增加。此前尚未在针对暴食症（BED）的iCBT中研究过这种关联。
在本研究中，我们假设轻度至中度BED患者所写的单词数量与基于文本的iCBT程序中治疗完成的可能性增加有关。
我们比较了143名BED患者（92名完成治疗者和51名未完成治疗者）在治疗期间给治疗师写的信息数量和单词数量。
完成治疗者每条信息写的单词数（单词/信息）明显多于未完成治疗者。在控制了性别、年龄、教育水平、婚姻状况、子女情况、收入来源以及BED、BMI和抑郁症状的摄入指标后，结果仍然显著（Wald = 14.48，P <.001）。患者每条信息多写一个单词，完成治疗的优势比增加1.5%（优势比 = 1.015）。该模型显示分类准确率为72.4%，区分完成治疗者和未完成治疗者的最佳临界点为68.99单词/信息。该模型准确识别了80.9%的完成治疗者（敏感性）和54.9%的未完成治疗者（特异性）。
患者每条信息写的单词数量可能对确定坚持治疗的可能性和提高坚持率具有重要意义。从临床角度来看，治疗师应鼓励患者使用给治疗师写信息的选项。单词/信息可能被证明是基于文本的iCBT中治疗坚持的跨诊断预测指标。
