Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 30:1:23.
doi: 10.1186/2050-2974-1-23. eCollection 2013.

Internet-based relapse prevention for anorexia nervosa: nine- month follow-up

Manfred Maximilian Fichter  1 , Norbert Quadflieg  2 , Susanne Lindner  2
Affiliations

Internet-based relapse prevention for anorexia nervosa: nine- month follow-up

Manfred Maximilian Fichter et al. J Eat Disord. .

Abstract

Background: To study the longer term effects of an internet-based CBT intervention for relapse prevention (RP) in anorexia nervosa.

Methods: 210 women randomized to the RP intervention group (full and partial completers) or the control group were assessed for eating and general psychopathology. Multiple regression analysis identified predictors of favorable course concerning Body Mass Index (BMI). Logistic regression analysis identified predictors of adherence to the RP program.

Results: Most variables assessed showed more improvement for the RP than for the control group. However, only some scales reached statistical significance (bulimic behavior and menstrual function, assessed by expert interviewers blind to treatment condition). Very good results (BMI) were seen for the subgroup of "full completers" who participated in all nine monthly RP internet-based intervention sessions. "Partial completers" and controls (the latter non-significantly) underwent more weeks of inpatient treatment during the study period than "full completers", indicating better health and less need for additional treatment among the "full completers". Main long-term predictors for favorable course were adherence to RP, more spontaneity, and more ineffectiveness. Main predictors of good adherence to RP were remission from lifetime mood and lifetime anxiety disorder, a shorter duration of eating disorder, and additional inpatient treatment during RP.

Conclusions: Considering the high chronicity of AN, internet-based relapse prevention following intensive treatment appears to be promising.

Keywords: Adherence; Anorexia nervosa; Eating disorder; Follow-up; Internet; Internet-based prevention; Maintenance; Online psychotherapy; Relapse prevention; Risk of relapse.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Consort diagram of sample flow.
Figure 2
Figure 2
Course of body weight (BMI) in full RP completers, partial RP completers, and controls, excluding participants who were pregnant at the time of assessment. Means and standard deviations are indicated for each data point.
See this image and copyright information in PMC

References

    1. Moessner M, Bauer S. Online counseling for eating disorders: reaching an underserved population? J Ment Health. 2012;1:336–345. doi: 10.3109/09638237.2011.643512. - DOI - PubMed
    1. Wilson GT, Zandberg LJ. Cognitive behavioral guided self-help for eating disorders: Effectiveness and scalability. Clin Psychol Rev. 2012;1:343–357. doi: 10.1016/j.cpr.2012.03.001. - DOI - PubMed
    1. Runge C, Lecheler J, Horn M, Tews JT, Schaefer M. Outcomes of a web-based patient education program for asthmatic children and adolescents. Chest. 2006;1:581–593. doi: 10.1378/chest.129.3.581. - DOI - PubMed
    1. Kuhl EA, Sears SF, Conti JB. Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: A review of cardiac disease-specific applications. Heart Lung. 2006;1:374–382. doi: 10.1016/j.hrtlng.2006.02.004. - DOI - PubMed
    1. Billings DW, Cook RF, Hendrickson A, Dove DC. A web-based approach to managing stress and mood disorders in the workforce. J Occup Environ Med. 2008;1:960–968. doi: 10.1097/JOM.0b013e31816c435b. - DOI - PMC - PubMed

LinkOut - more resources