Randomised controlled trial of CD-ROM-based cognitive-behavioural self-care for bulimia nervosa.
BACKGROUND
Cognitive-behavioural self-care is advocated as a first step in the treatment of bulimia nervosa.


OBJECTIVE
To examine the effectiveness of a CD-ROM-based cognitive-behavioural intervention in bulimia nervosa and eating disorder not otherwise specified (NOS) (bulimic type) in a routine setting.


METHODS
Ninety-seven people with bulimia nervosa or eating disorder NOS were randomised to either CD-ROM without support for 3 months followed by a flexible number of therapist sessions or to a 3-month waiting list followed by 15 sessions of therapist cognitive-behavioural therapy (CBT) (ISRCTN51564819). Clinical symptoms were assessed at pre-treatment, 3 months and 7 months.


RESULTS
Only two-thirds of participants started treatment. Although there were significant group x time interactions for bingeing and vomiting, favouring the CD-ROM group at 3 months and the waiting-list group at 7 months, post hoc group comparisons at 3 and 7 months found no significant differences for bingeing or vomiting. CD-ROM-based delivery of this intervention, without support from a clinician, may not be the best way of exploiting its benefits.
Schmidt
U
U
Section of Eating Disorders, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AZ, UK. u.schmidt@iop.kcl.ac.uk
Andiappan
M
M
Grover
M
M
Robinson
S
S
Perkins
S
S
Dugmore
O
O
Treasure
J
J
Landau
S
S
Eisler
I
I
Williams
C
C
D000328:Adult; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D016251:CD-ROM; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012648:Self Care / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists