title: Internet-delivered cognitive-behavioural therapy v. conventional guided self-help for bulimia nervosa: long-term evaluation of a randomised controlled trial.
abstract: BACKGROUND
  Cognitive-behavioural therapy (CBT)-based guided self-help is recommended as a first step in the treatment of bulimia nervosa.
  
  
  OBJECTIVE
  To evaluate in a randomised controlled trial (Clinicaltrials.gov registration number: NCT00461071) the long-term effectiveness of internet-based guided self-help (INT-GSH) compared with conventional guided bibliotherapy (BIB-GSH) in females with bulimia nervosa.
  
  
  METHODS
  A total of 155 participants were randomly assigned to INT-GSH or BIB-GSH for 7 months. Outcomes were assessed at baseline, month 4, month 7 and month 18.
  
  
  RESULTS
  The greatest improvement was reported after 4 months with a continued reduction in eating disorder symptomatology reported at month 7 and 18. After 18 months, 14.6% (n = 7/48) of the participants in the INT-GSH group and 25% (n = 7/28) in the BIB-GSH group were abstinent from binge eating and compensatory measures, 43.8% (n = 21/48) and 39.2% (n = 11/28) respectively were in remission. No differences regarding outcome between the two groups were found.
  
  
  CONCLUSIONS
  Internet-based guided self-help for bulimia nervosa was not superior compared with bibliotherapy, the gold standard of self-help. Improvements remain stable in the long term.
authors.affiliation: Eating Disorders Unit at Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Wagner
authors.forename: Eva
authors.initials: E
authors.lastname: Penelo
authors.forename: Christian
authors.initials: C
authors.lastname: Wanner
authors.forename: Paulina
authors.initials: P
authors.lastname: Gwinner
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Trofaier
authors.forename: Hartmut
authors.initials: H
authors.lastname: Imgart
authors.forename: Karin
authors.initials: K
authors.lastname: Waldherr
authors.forename: Ciçek
authors.initials: C
authors.lastname: Wöber-Bingöl
authors.forename: Andreas F K
authors.initials: AF
authors.lastname: Karwautz
mesh_terms: D000293:Adolescent; D000328:Adult; D001638:Bibliotherapy; D002032:Bulimia / Q000517:prevention & control; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D016014:Linear Models; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010352:Patient Dropouts; D012074:Remission Induction / Q000379:methods; D012648:Self Care / Q000379:methods*; D013813:Therapy, Computer-Assisted; D014839:Vomiting / Q000517:prevention & control; D055815:Young Adult