title: Investigating the use of CD-Rom CBT for bulimia nervosa and binge eating disorder in an NHS adult outpatient eating disorders service.
abstract: BACKGROUND
  Many patients who experience bulimia nervosa (BN) and binge eating disorder (BED) find it hard to access evidence-based treatments. Rates of failure to enter outpatient services following initial assessment are high, as are dropout rates from specialist outpatient eating disorders services.
  
  
  OBJECTIVE
  To offer CD-Rom CBT, a cognitive-behavioural multi-media supported self-help treatment, in a locality-based outpatient NHS Eating Disorders Service to patients who have binge eating disorder and bulimia nervosa.
  
  
  METHODS
  Patients referred to a catchment-based NHS outpatient eating disorders service who were assessed and had an eating disorder with a binge-eating component were offered CD-Rom based CBT (Overcoming Bulimia) whilst on the waiting list for individual CBT.
  
  
  RESULTS
  Forty patients completed the 8 sessions and attended the evaluation appointment (13 had BN, 27 had BED). For both groups, there were significant improvements in well-being and functioning, as well as significant reductions in problems and risk. There was also a significant reduction on the "Bulimic Subscale" of the EDI. These results were comparable with the original study findings (Schmidt, Treasure and Williams, 2001). Dropouts from the CD-Rom reflected rates common to other EDS treatments suggesting that CD-Rom did not directly impact upon service dropout rates.
  
  
  CONCLUSIONS
  Computer assisted CBT for Eating Disorders offers a promising, feasible and acceptable first step for patients who have bulimia nervosa or binge eating disorder and access treatment from specialist eating disorders services.
authors.affiliation: Lancashire Care NHS Foundation Trust, Chorley, UK. lisa.graham@lancashirecare.nhs.uk
authors.forename: Lisa
authors.initials: L
authors.lastname: Graham
authors.forename: Mark
authors.initials: M
authors.lastname: Walton
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D056912:Binge-Eating Disorder / Q000523:psychology / Q000628:therapy*; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D016251:CD-ROM; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services; D004739:England; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012648:Self Care; D013222:State Medicine; D013813:Therapy, Computer-Assisted / Q000379:methods*; D055815:Young Adult