Linardon Jake, Jarman Hannah K, Liu Claudia, Anderson Cleo, McClure Zoe, Messer Mariel
SEED Lifespan Strategic Research Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
Int J Eat Disord. 2025 May;58(5):815-831. doi: 10.1002/eat.24405. Epub 2025 Mar 3.
Self-help programs are recommended as a first step in the management of eating disorders. Yet, whether self-help interventions have broader mental health benefits beyond symptom and risk reduction remains unclear. As randomized controlled trials (RCTs) also assess general mental health secondary to eating disorder symptoms, we conducted a meta-analysis to investigate whether and to what extent pure self-help interventions for eating disorders produce improvements in these secondary outcomes.
Twenty-seven RCTs of pure self-help interventions for the prevention or treatment of eating disorders were included. Mean age ranged from 16 to 46 years. Most self-help interventions were based on cognitive-behavioral therapy. Most interventions were delivered via digital means (Internet, apps, etc.). Random effects meta-analyses were conducted on six outcomes: depression, anxiety, general distress, quality of life, self-esteem, and psychosocial impairment. Analyses were stratified based on pre-selected (at risk/symptomatic) and clinical samples.
For pre-selected samples (k = 18), significant pooled effects favoring self-help over controls were observed for depression (g = 0.24), anxiety (g = 0.23), distress (g = 0.23) and self-esteem (g = 0.18). Effects remained robust when adjusting for risk of bias. Non-significant effects were observed for quality of life and impairment. Crucially, > 80% of trials on pre-selected samples delivered a waitlist control. For clinical samples (k = 9), significant pooled effects favoring self-help were found for distress (g = 0.39), impairment (g = 0.39), and quality of life (g = 0.29), although these results should be interpreted with caution as the number of studies was low.
Self-help interventions produce small improvements in those mental health symptoms that are typically comorbid with eating disorders.
自助项目被推荐为饮食失调管理的第一步。然而，自助干预是否除了减轻症状和降低风险外还具有更广泛的心理健康益处仍不清楚。由于随机对照试验（RCT）也评估饮食失调症状继发的一般心理健康状况，我们进行了一项荟萃分析，以调查针对饮食失调的纯自助干预是否以及在多大程度上能改善这些次要结果。
纳入了27项针对饮食失调预防或治疗的纯自助干预的随机对照试验。平均年龄在16至46岁之间。大多数自助干预基于认知行为疗法。大多数干预通过数字手段（互联网、应用程序等）提供。对六个结果进行了随机效应荟萃分析：抑郁、焦虑、一般痛苦、生活质量、自尊和社会心理损害。分析根据预先选择的（有风险/有症状）和临床样本进行分层。
对于预先选择的样本（k = 18），在抑郁（g = 0.24）、焦虑（g = 0.23）、痛苦（g = 0.23）和自尊（g = 0.18）方面，观察到支持自助优于对照的显著合并效应。在调整偏倚风险后，效应仍然稳健。生活质量和损害方面观察到不显著的效应。至关重要的是，超过80%的针对预先选择样本的试验采用了等待名单对照。对于临床样本（k = 9），在痛苦（g = 0.39）、损害（g = 0.39）和生活质量（g = 0.29）方面发现了支持自助的显著合并效应，不过由于研究数量较少，这些结果应谨慎解释。
自助干预在那些通常与饮食失调共病的心理健康症状方面产生了微小改善。
