Abstract
Objective: To investigate the effectiveness and cost per participant in remission (CPPR) of a 12 week guided self-help (GSH) cognitive behavioural therapy course, with professionally-led group support for adults with bulimia (BN) and binge eating disorder (BED), in comparison to one-to one integrative psychotherapy (IP) of individualised duration.
Method: Pre-treatment data were gathered on 66 participants who were assigned by their own choice to either treatment condition. End of treatment data were gathered for treatment completers. GSH offered treatment in less than 10 weeks whereas IP had standard waiting times of 10-20 weeks. The primary outcome variable was remission of binge eating per participant’s self-report. Additional variables included psychological features associated with eating disorders. Measures included CORE, PHQ-9, GAD-7 and Sterling Eating Disorder Scales.
Results: 56.2% (n=18) of GSH completers achieved remission at end of the course. GSH CPPR was £1,151.90, which includes the cost for 5 participants who went on for further treatment. The course produced statistically significant improvement on all psychological variables except low assertiveness and perceived external control. Those who did not achieve remission in 12 weeks had significantly higher baseline anxiety scores, and 76.9% had a concurrent mood disorder. The GSH group had 7.3% attrition (all but two participants attended 9 or more of the 12 sessions), whereas 46.4% of the IP group either dropped out (DO) or did not return after assessment (DNR). The DO/DNR’s were characterised by waiting longer than 10 weeks to be offered treatment; bulimia; lower body mass index; and less severe bulimic dietary behaviour by self-report. IP CPPR was £1950 .00 which included cost of resources spent on DO/DNR.
Conclusion: Guided self-help for BN and BED can offer cost-effective treatment with rapid access and high acceptability for clients with binge eating and bulimia. Short-term results are generally better for those who do not have a co-morbid mood or anxiety disorder. Waits of more than 10 weeks from referral to access psychological treatment is associated with attrition and dissipated resources. More research on cost-effectiveness and in particular, quality adjusted life years (QALY) for eating disorders treatments is required.
Method: Pre-treatment data were gathered on 66 participants who were assigned by their own choice to either treatment condition. End of treatment data were gathered for treatment completers. GSH offered treatment in less than 10 weeks whereas IP had standard waiting times of 10-20 weeks. The primary outcome variable was remission of binge eating per participant’s self-report. Additional variables included psychological features associated with eating disorders. Measures included CORE, PHQ-9, GAD-7 and Sterling Eating Disorder Scales.
Results: 56.2% (n=18) of GSH completers achieved remission at end of the course. GSH CPPR was £1,151.90, which includes the cost for 5 participants who went on for further treatment. The course produced statistically significant improvement on all psychological variables except low assertiveness and perceived external control. Those who did not achieve remission in 12 weeks had significantly higher baseline anxiety scores, and 76.9% had a concurrent mood disorder. The GSH group had 7.3% attrition (all but two participants attended 9 or more of the 12 sessions), whereas 46.4% of the IP group either dropped out (DO) or did not return after assessment (DNR). The DO/DNR’s were characterised by waiting longer than 10 weeks to be offered treatment; bulimia; lower body mass index; and less severe bulimic dietary behaviour by self-report. IP CPPR was £1950 .00 which included cost of resources spent on DO/DNR.
Conclusion: Guided self-help for BN and BED can offer cost-effective treatment with rapid access and high acceptability for clients with binge eating and bulimia. Short-term results are generally better for those who do not have a co-morbid mood or anxiety disorder. Waits of more than 10 weeks from referral to access psychological treatment is associated with attrition and dissipated resources. More research on cost-effectiveness and in particular, quality adjusted life years (QALY) for eating disorders treatments is required.
| Original language | English |
|---|---|
| Title of host publication | British Psychological Society Annual Conference |
| Number of pages | 29 |
| Publication status | Published - 5 May 2011 |
| Event | The British Psychological Society Annual Conference 2011 - Glasgow, United Kingdom Duration: 4 May 2011 → 6 May 2011 |
Conference
| Conference | The British Psychological Society Annual Conference 2011 |
|---|---|
| Country/Territory | United Kingdom |
| City | Glasgow |
| Period | 4/05/11 → 6/05/11 |
Keywords
- guided self help
- bulimia
- binge eating disorder
- Cost effectiveness analysis