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Self-help and guided self-help for eating disorders.

S J Perkins, R Murphy, U Schmidt

    The Cochrane Database of Systematic Reviews
    |July 21, 2006
    PubMed
    Summary
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    Pure self-help (PSH) and guided self-help (GSH) show potential for treating eating disorders, offering an alternative to traditional therapies. Further research is needed to confirm their efficacy and explore different delivery methods.

    Area of Science:

    • Psychiatry
    • Psychology
    • Clinical Psychology

    Background:

    • Eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, are prevalent and debilitating conditions.
    • Access to specialized psychological treatments for eating disorders is often limited.
    • Pure self-help (PSH) and guided self-help (GSH) interventions may help address this treatment gap.

    Purpose of the Study:

    • To evaluate the efficacy of PSH and GSH for eating disorder symptoms using randomized controlled trials (RCTs) and controlled clinical trials (CCTs).
    • To compare PSH/GSH against waiting lists, placebo/attention controls, and other psychological or pharmacological treatments.
    • To assess the impact of PSH/GSH on comorbid symptomatology and healthcare costs.

    Main Methods:

    Related Experiment Videos

  • A systematic search of multiple databases (CCDANCTR, etc.) and grey literature was conducted up to November 2005.
  • Included published and unpublished RCTs/CCTs evaluating PSH/GSH for any eating disorder in adults.
  • Data extraction and analysis involved calculating Risk Ratios (RR) and weighted/standardized mean differences (WMD/SMD) using a random effects model.

    • Main Results:

    • PSH/GSH did not significantly differ from waiting lists in abstinence from bingeing or purging, but improved other eating disorder symptoms and interpersonal functioning.
    • Compared to formal psychological therapies, PSH/GSH showed no significant differences in outcomes at end of treatment or follow-up.
    • No significant differences in treatment dropout rates were observed between PSH/GSH and other interventions.

    Conclusions:

    • PSH/GSH may serve as a valuable first step in eating disorder treatment and an alternative to therapist-delivered therapy.
    • Further large-scale, well-conducted studies are recommended, focusing on health economics, varied delivery methods (e.g., computerized), and diverse populations.
    • Specific types of PSH/GSH demonstrated significant differences in eating disorder symptom improvement, though not in bingeing/purging abstinence rates.