From: Internet-based interventions for eating disorders in adults: a systematic review
Authors | Ljotsson et al. [16] | Robinson & Serfaty [17] | Johnston et al. [15] | Carrard et al. [12] | Sanchez-Ortiz et al. [19] | Fernandez-Aranda et al. [14] | Carrard et al. [13] | Ruwaard et al. [18] |
---|---|---|---|---|---|---|---|---|
Type of study/ Randomisation | RCT: based on generated random numbers; Stratification procedure was implemented with regard to diagnosis and severity | RCT: randomization was based on generated random numbers | RCT: No exact description was given | RCT: Randomization was based on generated random numbers | RCT: based on generated random numbers; Stratification procedure was implemented with regard to diagnosis and recruitment site | CT: participants were consecutively assigned to either the treatment group or the control group | CT: participants were either offered to take part in the treatment program or asked to participate in the control group during information session for WLT | RCT: randomization was based on generated random numbers |
Intervention | Self- help based on CBT using the Swedish translation of the book “Overcoming Binge Eating” | Email therapy based on CBT working on a model of the eating disorder | 20 minutes writings on the basis of the Pennebaker task | Guided self-help treatment program consisting of 11 modules based on CBT targeting behavioural and psychological aspects of BED | guided self-help treatment program “Overcoming Bulimia Online” consisting of eight sessions based on CBT | Guided self-help program introducing CBT and psychoeducational concepts in seven sequential stepsc | Guided self-help program and consisting of 11 modules based on CBT targeting behavioural and psychological aspects of BED | Guided self-help program referring to CBT main principles for treatment of BN |
Anonymity | No: EDE interview was performed as main assessment | Yes: no interview or face-to-face meeting was conducted | Yes: no interview or face-to-face meeting was conducted | three additional face-to-face evaluations during a year | introduction in a face-to-face meeting or as telephone assessment | No: two face-to-face evaluations with their coaches during therapy | no: three additional face-to-face evaluations | Yes: only an interview with a diagnostician |
Lengths | 12 weeks | Three months | Three days | Six months | 8 to 12 weeks | Four months | Six months | 20 weeks |
Frequency of contact | One to two email contacts per week | On average two emails per week were expected | No contact at all during therapy | Weekly e-mail contact during the intervention phase; monthly e-mail contact during the follow-up period | Therapists sent emails once every one to two weeks and responded to any email received | Weekly e-mail contact with their coach during intervention phase | Therapists sent weekly e-mails and participants had to write at least one email each week to their coaches | Treatment includes 25 scheduled therapist feedback moments |
Number and diagnosis of participants | 73 participants with full or sub-threshold Bulimia Nervosa (BN) or Binge Eating Disorder (BED) diagnosis according to DSM-IV; sub-threshold BN was defined as episodes of binge eating and compensatory behaviour at least twice-monthly for the last three months. BED participants needed to have at least two OBEs per month for the last six months | 97 participants suffering from BN (n = 36 purging; n =15 non-purging), BED (n = 26) or EDNOS (n = 20) diagnosis according to DSM-IV | 94 participants suffering from BN; Participants were required to score at or above the medium-range cut off for bulimic symptomatology | 74 participants suffering from BED (n = 43) or sub-threshold BED (n = 31) diagnosis according to DSM-IV; for sub-threshold BED participants needed to have at least one OBE weekly for the last three months | 76 students suffering from BN (n = 39) or EDNOS (n = 37) diagnosis according to DSM-IV; persons suffering from BED were excluded | 62 participants suffering from BN purging subtype; diagnosis according to DSM-IV | 42 obese participants suffering from BED (n = 21) or sub-threshold BED (n = 21); diagnosis according to DSM-IV; Frequency of binges had to be at least for once a month during the last three months | 105 participants suffering from BN symptoms (80% engaged in purging behaviour) |
A formal diagnosis of BN was not an inclusion criteria. Participants had to report recurrent binge eating, inappropriate weight-control behaviour and elevated concern with body shape and weight | ||||||||
Women N (%) | 69 (97.3%) | 93 (95.9%) | 71 (75.5%) | 74 (100%) | 75 (98.7%) | 62 (100%) | 42 (100%) | 104 (99%) |
Age of participants M (SD) | Intervention Group: 35.5 (11.4) | Whole sample: 24.5 (23–25.9) | Whole sample: 28.9 (9.8) | Whole sample: 36 (11.4) | Whole sample: 23.9 (5.69) | Whole sample: 23.7 (3.6) | Intervention Group: 44.6 (11.4) | Online-CBT: 30 (10) |
Control group: 33.7 (9.3) | Control group: 41.0 (8.2) | Bibliotherapy: 31 (9) | ||||||
Waiting list group: 32 (11) |