Self-help techniques may play important role in eating disorders

Self-help therapies could potentially fill the gap between the high prevalence of binge-eating disorders in the general population and the lack of specialised professionals and services, say the authors of a recent review.Research has shown that bulimia nervosa (BN) and binge-eating disorder (BED) are prevalent but that as few as 10% of sufferers are receiving treatment. Although cognitive behavioural therapy (CBT) has been shown to be effective in BN, studies have shown that for some patients it is unnecessarily intensive while for others it is not sufficient. In some cases, less intensive therapies, such as self-help techniques which use highly structured audiovisual materials or manuals based in cognitive behavioural techniques, may be appropriate.In light of this, the researchers set out to evaluate the efficacy of self-help techniques in the treatment of BN and BED by conducting a systematic review of randomised controlled trials comparing them with waiting list or no treatment, or a control psychotherapy.Of 2,686 articles identified in a literature search, nine were deemed suitable for inclusion in the review. Sufficient data were obtained to allow the researchers to conduct five meta-analyses. In the first, patients receiving any kind of self-help showed significantly higher remission rates than those in the waiting list (26.5% vs 6.5%). The researchers observed no significant difference between the groups in terms of rates of treatment non-completers.In the remaining four meta-analyses, (pure self-help vs waiting list, guided self-help vs waiting list, guided self-help vs pure self-help, and any form of self-help vs CBT), the researchers found no significant difference between groups in terms of remission rates or rates of treatment non-completers.The researchers state that their findings appear promising, and provide support for the judicious use of self-help and its applicability as a stand-alone therapy or use in a stepped-care approach. They conclude that further research is needed, and should focus on which components of self-help techniques are more efficient, which patient sub-groups would benefit from differing techniques, if length of therapy is important and if positive effects are sustained at follow-up.Future studies should include larger patient samples of males and females, and should employ standardised inclusion criteria, evaluation tools, self-help material and approaches.Reference...