Dimitra Anastasiadou1,2, Frans Folkvord2,3, Agostino Brugnera4, Laura Cañas Vinader5,6, Eduardo SerranoTroncoso5,6, Cristina Carretero Jardí7, Raquel Linares Bertolin7, Rudiger Muñoz Rodríguez8, Beatriz Martínez Nuñez8, Montserrat Graell Berna8, Jordi Torralbas-Ortega9, Lidia Torrent-Solà9, Joaquim Puntí-Vidal9,10, Maria Carrera Ferrer11, Andrea Muñoz Domenjó12, Marina Diaz Marsa13, Katarina Gunnard14, Jordi Cusido15,16, Jordina Arcal Cunillera15,16, Francisco Lupiañez-Villanueva1,2. 1. Department of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain. 2. Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain. 3. Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands. 4. Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy. 5. Child and Adolescent Psychiatry and Psychology Department, Sant Joan de Déu Hospital of Barcelona, Esplugues de Llobregat, Spain. 6. Children and Adolescent Mental Health Research Group, Sant Joan de Déu Research Institut, Esplugues de Llobregat, Spain. 7. Eating Disorders Unit, ABB Center, Barcelona, Spain. 8. Child and Adolescent Psychiatry and Psychology Service, Niño Jesús University Children's Hospital, Madrid, Spain. 9. Child and Adolescent Mental Health Service, Parc Taulí Foundation, Research and Innovation Institute Parc Taulí (I3PT) - Autonomous University of Barcelona, Sabadell, Spain. 10. Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), Spain. 11. Eating Disorders Programme IBSMIA, University Hospital Son Espases, Palma de Mallorca, Spain. 12. Department of Psychiatry, University Hospital Móstoles, Móstoles, Spain. 13. Eating Disorders Unit, San Carlos University Hospital, Madrid, Spain. 14. Eating Disorders Unit, Quirón Dexeus University Hospital, Barcelona, Spain. 15. Board Member, HealthApp SL, Sabadell, Spain. 16. Department of Engineering Projects, Universitat Politècnica de Catalunya, Barcelona, Spain.
Abstract
OBJECTIVE: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.
RCT Entities:
OBJECTIVE: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.
Authors: Kate Bartolotta; Sarah E Broner; Colleen S Conley; Elizabeth B Raposa; Maya Hareli; Nicola Forbes; Kirsten M Christensen; Mark Assink Journal: JMIR Ment Health Date: 2022-07-29