The British Journal of Psychiatry (2008) 193: 493-500. doi: 10.1192/bjp.bp.107.046607
© 2008 The Royal College of Psychiatrists
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Randomised controlled trial of CD–ROM-based cognitive–behavioural self-care for bulimia nervosa

U. Schmidt, MRCPsych

Section of Eating Disorders, Institute of Psychiatry, London

M. Andiappan, BSc, MSc

Department of Biostatistics and Computing, Institute of Psychiatry, London

M. Grover, MSc

Section of Eating Disorders, Institute of Psychiatry, London

S. Robinson

Section of Family Therapy, Institute of Psychiatry, London

S. Perkins

Section of Eating Disorders, Institute of Psychiatry, London

O. Dugmore

Section of Family Therapy, Institute of Psychiatry, London

J. Treasure, FRCPsych

Section of Eating Disorders, Institute of Psychiatry, London

S. Landau, PhD

Department of Biostatistics and Computing, Institute of Psychiatry, London

I. Eisler, PhD

Section of Family Therapy, Institute of Psychiatry, London

C. Williams, FRCPsych

Section of Psychological Medicine, University of Glasgow, UK

Correspondence: Ulrike Schmidt, PO 59, Section of Eating Disorders, Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AZ, UK. Email: u.schmidt{at}iop.kcl.ac.uk

Declaration of interest

C.W. receives royalties for the CD–ROM intervention. Funding details in Acknowledgements.

Background

Cognitive–behavioural self-care is advocated as a first step in the treatment of bulimia nervosa.

Aims

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.

Method

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.


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