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一项针对暴饮暴食症的支持性在线自助治疗方案的可接受性、可行性及初步疗效

The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder.

作者信息

Rom Sean, Miskovic-Wheatley Jane, Barakat Sarah, Aouad Phillip, Kim Marcellinus, Fuller-Tyszkiewicz Matthew, Maguire Sarah

机构信息

Faculty of Health, School of Psychology, Deakin University, Geelong, VIC, Australia.

InsideOut Institute, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia.

出版信息

Front Psychiatry. 2023 Oct 4;14:1229261. doi: 10.3389/fpsyt.2023.1229261. eCollection 2023.

Abstract

INTRODUCTION

Studies in transdiagnostic eating disorder (ED) samples suggest supported online self-help programs (eTherapies) are effective and may improve access to treatment; however, their evaluation in those with binge-eating disorder (BED) is limited. Given BED's high prevalence and low levels of treatment uptake, further eTherapy evaluation is needed to broaden access to effective, evidence-based treatment options. The aim of this study was to investigate the acceptability, feasibility, and preliminary efficacy of a supported eTherapy for those with BED or subthreshold BED, and to examine symptom change across the duration of therapy.

METHOD

Nineteen women with BED completed a supported, 10-session Cognitive Behavioural Therapy-based eTherapy in an uncontrolled, pre-post, and 3 months follow up intervention study. Key outcomes were assessed by the Eating Disorder Examination Questionnaire (EDE-Q): objective binge episode (OBE) frequency and ED psychopathology. Feasibility was evaluated via program adherence and dropout, whilst acceptability was assessed through participant feedback post-treatment. Weekly symptom change (ED psychopathology) during treatment was assessed by the Eating Disorder Examination - Questionnaire Short (EDE-QS).

RESULTS

Generalised estimating equations showed statistically and clinically significant reductions in OBEs and ED psychopathology (large effects) post-treatment, with these decreases maintained at follow up. Across weekly assessment, a marked slowing in the rate of change in ED psychopathology was observed after four sessions of the program. Program feasibility was high (i.e., 84% of content completed), as was program acceptability (i.e., 93% of participants expressed high levels of satisfaction).

DISCUSSION

These results support the acceptability, feasibility, and preliminary efficacy of a supported eTherapy program for those with BED and suggest the variability of symptom change across the duration of therapy. Future research should further investigate findings in an adequately powered randomised controlled trial.

摘要

引言

对跨诊断饮食失调(ED)样本的研究表明,有支持的在线自助项目(电子疗法)是有效的,并且可能改善治疗的可及性;然而,它们在神经性贪食症(BED)患者中的评估有限。鉴于BED的高患病率和低治疗利用率,需要进一步评估电子疗法,以扩大获得有效、基于证据的治疗选择的机会。本研究的目的是调查一种有支持的电子疗法对患有BED或亚阈值BED的患者的可接受性、可行性和初步疗效,并检查整个治疗过程中的症状变化。

方法

19名患有BED的女性在一项非对照、前后对照和3个月随访干预研究中完成了一个有支持的、基于认知行为疗法的10节电子疗法课程。主要结果通过饮食失调检查问卷(EDE-Q)进行评估:客观暴食发作(OBE)频率和ED精神病理学。通过项目依从性和退出情况评估可行性,同时通过治疗后参与者的反馈评估可接受性。治疗期间每周的症状变化(ED精神病理学)通过饮食失调检查-问卷简表(EDE-QS)进行评估。

结果

广义估计方程显示,治疗后OBE和ED精神病理学有统计学和临床意义的显著降低(效果显著),这些降低在随访中得以维持。在每周评估中,该项目进行到四四四课程的四节之后,观察到ED精神病理学变化率明显放缓。项目可行性较高(即84%的内容完成),项目可接受性也较高(即93%的参与者表示高度满意)。

讨论

这些结果支持了一种有支持的电子疗法项目对患有BED的患者的可接受性、可行性和初步疗效,并表明整个治疗过程中症状变化的可变性。未来的研究应在有足够样本量的随机对照试验中进一步调查这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a960/10584326/5a62d2fbed66/fpsyt-14-1229261-g001.jpg

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