Guided self-help versus cognitive-behavioral group therapy in the treatment of bulimia nervosa.
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.
Bailer
Ursula
U
Department of General Psychiatry, University Hospital of Psychiatry, Medical University of Vienna, Vienna, Austria. ursula.bailer@meduniwien.ac.at
de Zwaan
Martina
M
Leisch
Friedrich
F
Strnad
Alexandra
A
Lennkh-Wolfsberg
Claudia
C
El-Giamal
Nadia
N
Hornik
Kurt
K
Kasper
Siegfried
S
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