GGZ Rivierduinen Eating Disorders Ursula, Leiden, Netherlands.
Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands.
Int J Eat Disord. 2022 Oct;55(10):1361-1373. doi: 10.1002/eat.23785. Epub 2022 Jul 30.
Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination.
A randomized controlled trial with a 12-month follow-up period was conducted. Participants aged 16 or older with at least mild eating disorder symptoms were randomized to four conditions: (1) Featback, a fully automated online self-help intervention, (2) chat or email support from a recovered expert patient, (3) Featback with expert-patient support and (4) a waiting list control condition. The intervention period was 8 weeks and there was a total of six online assessments. The main outcome constituted reduction of eating disorder symptoms over time.
Three hundred fifty five participants, of whom 43% had never received eating disorder treatment, were randomized. The three active interventions were superior to a waitlist in reducing eating disorder symptoms (d = -0.38), with no significant difference in effectiveness between the three interventions. Participants in conditions with expert-patient support were more satisfied with the intervention.
Internet-based self-help, expert-patient support and their combination were effective in reducing eating disorder symptoms compared to a waiting list control condition. Guidance improved satisfaction with the internet intervention but not its effectiveness. Low-threshold interventions such as Featback and expert-patient support can reduce eating disorder symptoms and reach the large group of underserved individuals, complementing existing forms of eating disorder treatment.
Individuals with eating-related problems who received (1) a fully automated internet-based intervention, (2) chat and e-mail support by a recovered individual or (3) their combination, experienced stronger reductions in eating disorder symptoms than those who received (4) usual care. Such brief and easy-access interventions play an important role in reaching individuals who are currently not reached by other forms of treatment.
许多饮食障碍患者未得到适当的治疗。低门槛干预措施可能有助于缩小这一治疗差距。本研究旨在评估 Featback 这一完全自动化的在线自助干预措施、在线医患支持及其组合的有效性。
一项为期 12 个月随访期的随机对照试验。纳入至少存在轻度饮食障碍症状且年龄在 16 岁及以上的参与者，随机分为四组：（1）Featback，一种完全自动化的在线自助干预措施；（2）与康复患者的在线聊天或电子邮件支持；（3）Featback 加医患支持；（4）等候名单对照条件。干预期为 8 周，共进行 6 次在线评估。主要结局是随时间推移饮食障碍症状的减少。
共纳入 355 名参与者，其中 43%的人从未接受过饮食障碍治疗，他们被随机分组。与等候名单相比，三种主动干预措施在减少饮食障碍症状方面更有效（d=-0.38），但三种干预措施之间的有效性无显著差异。有医患支持的组的参与者对干预的满意度更高。
与等候名单对照条件相比，基于互联网的自助、医患支持及其组合在减少饮食障碍症状方面更有效。指导提高了对互联网干预的满意度，但没有提高其有效性。Featback 和医患支持等低门槛干预措施可以减少饮食障碍症状，帮助那些未得到充分治疗的人群，补充现有的饮食障碍治疗方法。
与接受（1）完全自动化的基于互联网的干预、（2）康复患者的在线聊天和电子邮件支持或（3）两者结合的患者相比，患有与饮食相关问题的患者，饮食障碍症状的减轻程度更强，而接受（4）常规护理的患者则没有。这种简短且易于获取的干预措施在接触目前未接受其他治疗形式的患者方面发挥着重要作用。
