Online cognitive-behavioural treatment of bulimic symptoms: a randomized controlled trial.
BACKGROUND
Manualized cognitive-behavioural treatment (CBT) is underutilized in the treatment of bulimic symptoms. Internet-delivered treatment may reduce current barriers.


OBJECTIVE
This study aimed to assess the efficacy of a new online CBT of bulimic symptoms.


METHODS
Participants with bulimic symptoms (n = 105) were randomly allocated to online CBT, bibliotherapy or waiting list/delayed treatment condition. Data were gathered at pre-treatment, post-treatment and 1-year follow-up.


METHODS
The primary outcome measures were the Eating Disorder Examination Questionnaire (EDE-Q) and the frequency of binge eating and purging episodes. The secondary outcome measure was the Body Attitude Test.


RESULTS
Dropout from Internet treatment was 26%. Intention-to-treat ANCOVAs of post-test data revealed that the EDE-Q scores and the frequency of binging and purging reduced more in the online CBT group compared with the bibliotherapy and waiting list groups (pooled between-group effect size: d = 0.9). At 1-year follow-up, improvements in the online CBT group had sustained.


CONCLUSIONS
This study identifies online CBT as a viable alternative in the treatment of bulimic symptoms.
Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands. j.j.ruwaard@uva.nl
Jeroen
J
Ruwaard
Alfred
A
Lange
Janneke
J
Broeksteeg
Aitziber
A
Renteria-Agirre
Bart
B
Schrieken
Conor V
CV
Dolan
Paul
P
Emmelkamp
D000328:Adult; D000704:Analysis of Variance; D001638:Bibliotherapy / Q000379:methods; D002032:Bulimia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D009426:Netherlands; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014850:Waiting Lists