Study | Aftercare intervention | Comparator | Adjunctive treatment | Duration | N | BMI at inclusion | Primary outcome | Definition of relapse | Main findings |
---|---|---|---|---|---|---|---|---|---|
Fichter et al. [28] | Internet-based guided self-help intervention (IGSH) | TAU | Outpatient or inpatient treatment and medication possible | 9 months | 258 | IGSH: 17.8 ± 1.4 TAU: 17.7 ± 1.2 | BMI | None provided | Primary outcome No significant group difference in weight gain after controlling for dosage of adjunctive inpatient treatment as the GSH group received more inpatient treatment as the TAU group Secondary outcomes Patients of the GSH had improved scores on some self-report dimensions related to ED cognitions and behaviors |
Kaye et al. [25] | 20 mg Fluoxetine/day (adjustment possible by a blinded physician) | Placebo | Optional adjunctive outpatient CBT | One year | 35 | 89% average body weight | Prevention of relapse | Dropout from trial due to deteriorating clinical course (e.g. severe weight loss or severe ED symptoms), initiated by the patient, carer or physician | Primary outcome Significantly more patients receiving placebo had a relapse (dropped out) as compared to those receiving fluoxetine Secondary outcomes Patients who completed fluoxetine treatment over one year had higher weight, less ED symptoms, less obsessive thoughts, less depression and anxiety than the remaining group |
Neumayr et al. [23] | Smartphone-based guided self-help intervention (SGSH) | TAU | SGSH is additional to TAU | 8 weeks | 40 | SGSH: 19.1 ± 1.9 TAU: 18.6 ± 1.0 | BMI self-reported ED symptoms | None provided | Primary outcome No significant group difference in weight gain or self-reported ED symptoms Secondary outcomes High levels of adherence and acceptance of SGSH |
Parling et al. [29] | Acceptance and commitment therapy (ACT) | TAU | Optional additional daycare and other treatments; no additional psychotherapy for ACT patients | 19 sessions | 42 | ACT: 17.5 ± 2.3 TAU: 18.1 ± 2.6 | Good outcome defined as BMI ≥ 19 and EDE-Q global score ≤ 2.83 | None provided | Primary outcome No significant group difference in good outcome Secondary outcomes Significant improvements in BMI and ED symptoms across time in both groups |
Pike et al. [30] | Cognitive-behavior therapy (CBT) | Nutritional Counselling (NC) | Adjunctive pharmacotherapy possible | 50 sessions over one year | 33 | Not reported BMI at admission: CBT: 16.0 ± 2.1 NC: 15.2 ± 1.5 | Time to relapse | (a) BMI below 17.5 for more than 10 days (b) severe ED-related medical complications requiring inpatient care (c) exacerbation of non-ED psychopathology requiring other care | Primary outcome Patients in the CBT group had a significant longer relapse-free interval than patients receiving NC Secondary outcomes Patients in the CBT group showed a lower relapse rate and were more likely to meet criteria for good outcome |
Sternheim et al. [26] | Internet-based guided self-help intervention based on MANTRA (iMANTRA) added to TAU | TAU | iMANTRA is additional to TAU | 12 months | 41 | iMANTRA: 18.1 ± 2.2 TAU: 17.9 ± 1.4 | Not defined due to feasibility focus | None provided | iMANTRA feasible and acceptable Effect sizes for BMI, ED pathology and general psychopathology at 6 months were small and tended to favor iMANTRA at 12 months assessment |
Walsh et al. [24] | 60 mg Fluoxetine/day (adjustment possible) | Placebo | Adjunctive outpatient CBT with specific focus on relapse prevention | One year | 93 | Fluoxetine: 20.2 ± 0.5 Placebo: 20.5 ± 0.5 | Time to relapse | (a) BMI below 16.5 for 2 consecutive weeks (b) severe ED-related medical complications (c) imminent suicide risk (d) development of other severe psychiatric disorder | Primary outcome No difference in time to relapse between the fluoxetine and placebo group Secondary outcomes No difference in any secondary outcome between the fluoxetine and placebo group |