title: Predictors for good therapeutic outcome and drop-out in technology assisted guided self-help in the treatment of bulimia nervosa and bulimia like phenotype.
abstract: OBJECTIVE
  Technology assisted guided self-help has been proven to be effective in the treatment of bulimia nervosa (BN). The aim of this study was to determine predictors of good long-term outcome as well as drop-out, in order to identify patients for whom these interventions are most suitable.
  
  
  METHODS
  One hundred and fifty six patients with BN were assigned to either 7 months internet-based guided self-help (INT-GSH) or to conventional guided bibliotherapy (BIB-GSH), both guided by e-mail support. Evaluations were taken at baseline, after 4, 7, and 18 months. As potential predictors, psychiatric comorbidity, personality features, and eating disorder psychopathology were considered.
  
  
  RESULTS
  Higher motivation, lower frequency of binge eating, and lower body dissatisfaction at baseline predicted good outcome after the end of treatment. Lower frequency of binge eating predicted good outcome at long-term follow-up. Factors prediciting drop-out were higher depression and lower self-directedness at baseline.
  
  
  CONCLUSIONS
  Technology assisted self-help can be recommended for patients with a high motivation to change, lower binge-eating frequency and lower depression scores.
authors.affiliation: Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Wagner
authors.forename: Eva
authors.initials: E
authors.lastname: Penelo
authors.forename: Gerald
authors.initials: G
authors.lastname: Nobis
authors.forename: Anna
authors.initials: A
authors.lastname: Mayrhofer
authors.forename: Christian
authors.initials: C
authors.lastname: Wanner
authors.forename: Johanna
authors.initials: J
authors.lastname: Schau
authors.forename: Marion
authors.initials: M
authors.lastname: Spitzer
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: Fernando
authors.initials: F
authors.lastname: Fernandez-Aranda
authors.forename: Andreas
authors.initials: A
authors.lastname: Karwautz
mesh_terms: D000328:Adult; D001638:Bibliotherapy; D056912:Binge-Eating Disorder / Q000523:psychology / Q000628:therapy*; D001828:Body Image; D002032:Bulimia / Q000523:psychology / Q000628:therapy*; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy; D034742:Electronic Mail; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010352:Patient Dropouts; D010641:Phenotype; D011599:Psychopathology; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted
keywords: bulimia nervosa; outcome; treatment