A Randomized Trial of Virtual Reality-Based Cue Exposure Second-Level Therapy and Cognitive Behavior Second-Level Therapy for Bulimia Nervosa and Binge-Eating Disorder: Outcome at Six-Month Followup
A Randomized Trial of Virtual Reality-Based Cue Exposure Second-Level Therapy and Cognitive Behavior Second-Level Therapy for Bulimia Nervosa and Binge-Eating Disorder: Outcome at Six-Month Followup
Authors
Ferrer Garcia, Marta
Pla Sanjuanelo, Joana
Dakanalis, Antonios
Vilalta Abella, Ferran
Riva, Giuseppe
Fernandez Aranda, Fernando
Forcano, Laura
Riesco, Nadine
Sanchez, Isabel
Clerici, Massimo
Ribas Sabate, Joan
Andreu Gracia, Alexis
Escandon Nagel, Neli
Gomez Tricio, Osane
Tena, Virginia
Gutierrez Maldonado, Jose
Pla Sanjuanelo, Joana
Dakanalis, Antonios
Vilalta Abella, Ferran
Riva, Giuseppe
Fernandez Aranda, Fernando
Forcano, Laura
Riesco, Nadine
Sanchez, Isabel
Clerici, Massimo
Ribas Sabate, Joan
Andreu Gracia, Alexis
Escandon Nagel, Neli
Gomez Tricio, Osane
Tena, Virginia
Gutierrez Maldonado, Jose
Authors
Date
Datos de publicaciĆ³n:
10.1089/cyber.2017.0675
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Abstract
This article reviews the 6-month followup data of a randomized, multicenter, parallel-group study conducted at five clinical sites in three European cities, which compared two second-level treatments for bulimia nervosa (BN) and binge eating disorder (BED): virtual reality-based cue exposure therapy (VR-CET) versus additional cognitive behavioral therapy (A-CBT). Post-treatment outcomes of this study were previously published and details of its design can be found at clinicaltrials.gov (identifier: NCT02237300). This article focuses on the evolution of symptoms assessed after 6 months of followup in a subgroup of 58 patients from the original study. In this study 64 patients with eating disorders (EDs) (35 with BN and 29 with BED), who still showed active episodes of binge eating by the end of a structured CBT program (first-level treatment), were randomly assigned to one of two second-level treatments (A-CBT or VR-CET). Frequency of binge and purge episodes, and attitudinal features of binge-related EDs (bulimia, drive for thinness, and body dissatisfaction) were assessed before starting the second-level treatment (n = 64), at the end (n = 64), and at 6-month followup (n = 58). Mixed between-within subject analyses of variance were used to compare outcomes of both second-level treatments over time. Although both treatment conditions showed statistically significant improvements at the end and after 6-month followup, obtained reductions were greater after VR-CET, regarding binge and purge episodes, as well as the decrease of self-reported tendency to engage in overeating episodes. Accordingly, abstinence from binge episodes were higher in VR-CET than A-CBT at followup (70 percent vs. 26 percent, respectively; chi(2) = 11.711, p = 0.001). These results provide further support for the use of VR-CET as an effective second-level intervention for BN and BED treatment-resistant patients.