title: Guided self-help versus cognitive-behavioral group therapy in the treatment of bulimia nervosa.
abstract: OBJECTIVE
  The aim of the current study was to evaluate whether guided self-help was effective in the short and long term in the treatment of bulimia nervosa.
  
  
  METHODS
  Eighty-one patients with bulimia nervosa were randomly assigned to either a self-help manual with a maximum of 18 short weekly visits (guided self-help) or to 18 weekly 1.5-h sessions of cognitive-behavioral group therapy (CBT). The primary outcome variables were monthly frequencies of self-reported binge eating and vomiting episodes. Secondary outcome variables were eating disorder-related psychopathology (assessed with the Eating Disorders Inventory [EDI]) and depression (assessed by the Beck Depression Inventory [BDI]). Patients were followed up 1 year after the end of treatment.
  
  
  RESULTS
  A mixed-effects linear regression analysis indicated that subjects in both treatment conditions showed a significant decrease over time in binge eating and vomiting frequencies, in the scores of the EDI subscales, and in the BDI. Both treatment modalities led to a sustained improvement at follow-up. A separate analysis of the completer sample showed significantly higher remission rates in the self-help condition (74%) compared with the CBT condition (44%) at follow-up.
  
  
  CONCLUSIONS
  Guided self-help incorporating the use of a self-help manual offers an approach that can be effective in the short and long-term treatment of bulimia nervosa.
authors.affiliation: Department of General Psychiatry, University Hospital of Psychiatry, Medical University of Vienna, Vienna, Austria. ursula.bailer@meduniwien.ac.at
authors.forename: Ursula
authors.initials: U
authors.lastname: Bailer
authors.forename: Martina
authors.initials: M
authors.lastname: de Zwaan
authors.forename: Friedrich
authors.initials: F
authors.lastname: Leisch
authors.forename: Alexandra
authors.initials: A
authors.lastname: Strnad
authors.forename: Claudia
authors.initials: C
authors.lastname: Lennkh-Wolfsberg
authors.forename: Nadia
authors.initials: N
authors.lastname: El-Giamal
authors.forename: Kurt
authors.initials: K
authors.lastname: Hornik
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000293:Adolescent; D000328:Adult; D002032:Bulimia / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010349:Patient Compliance; D012657:Self-Help Groups; D011795:Surveys and Questionnaires