Internet-Based Cognitive Behavioral Therapy via Videoconference for Patients With Bulimia Nervosa and Binge-Eating Disorder: Pilot Prospective Single-Arm Feasibility Trial

Sayo Hamatani; Noriko Numata; Kazuki Matsumoto; Chihiro Sutoh; Hanae Ibuki; Keiko Oshiro; Mari Tanaka; Rikukage Setsu; Yohei Kawasaki; Yoshiyuki Hirano; Eiji Shimizu

doi:10.2196/15738

Internet-Based Cognitive Behavioral Therapy via Videoconference for Patients With Bulimia Nervosa and Binge-Eating Disorder: Pilot Prospective Single-Arm Feasibility Trial

JMIR Form Res. 2019 Oct 23;3(4):e15738. doi: 10.2196/15738.

Authors

Sayo Hamatani^{1

2}, Noriko Numata¹, Kazuki Matsumoto¹, Chihiro Sutoh³, Hanae Ibuki¹, Keiko Oshiro¹, Mari Tanaka³, Rikukage Setsu^{3

4}, Yohei Kawasaki⁵, Yoshiyuki Hirano¹, Eiji Shimizu^{1

3

6}

Affiliations

¹ Research Center for Child Mental Development, Chiba University, Chiba, Japan.
² Japan Society for the Promotion of Science, Tokyo, Japan.
³ Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁴ Koutokukai Sato Hospital, Yamagata, Japan.
⁵ Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan.
⁶ Cognitive Behavioral Therapy Center, Chiba University Hospital, Chiba, Japan.

PMID: 31647472
PMCID: PMC6914274
DOI: 10.2196/15738

Abstract

Background: A major problem in providing mental health services is the lack of access to treatment, especially in remote areas. Thus far, no clinical studies have demonstrated the feasibility of internet-based cognitive behavioral therapy (ICBT) with real-time therapist support via videoconference for bulimia nervosa and binge-eating disorder in Japan.

Objective: The goal of the research was to evaluate the feasibility of ICBT via videoconference for patients with bulimia nervosa or binge-eating disorder.

Methods: Seven Japanese subjects (mean age 31.9 [SD 7.9] years) with bulimia nervosa and binge-eating disorder received 16 weekly sessions of individualized ICBT via videoconference with real-time therapist support. Treatment included CBT tailored specifically to the presenting diagnosis. The primary outcome was a reduction in the Eating Disorder Examination Edition 16.0D (EDE 16D) for bulimia nervosa and binge-eating disorder: the combined objective binge and purging episodes, objective binge episodes, and purging episodes. The secondary outcomes were the Eating Disorders Examination Questionnaire, Bulimic Investigatory Test, Edinburgh, body mass index for eating symptoms, Motivational Ruler for motivation to change, EuroQol-5 Dimension for quality of life, 9-item Patient Health Questionnaire for depression, 7-item Generalized Anxiety Disorder scale for anxiety, and Working Alliance Inventory-Short Form (WAI-SF). All outcomes were assessed at week 1 (baseline) and weeks 8 (midintervention) and 16 (postintervention) during therapy. Patients were asked about adverse events at each session. For the primary analysis, treatment-related changes were assessed by comparing participant scores and 95% confidence intervals using the paired t test.

Results: Although the mean combined objective binge and purging episodes improved from 47.60 to 13.60 (71% reduction) and showed a medium effect size (Cohen d=-0.76), there was no significant reduction in the combined episodes (EDE 16D -41; 95% CI -2.089 to 0.576; P=.17). There were no significant treatment-related changes in secondary outcomes. The WAI-SF scores remained consistently high (64.8 to 66.0) during treatment.

Conclusions: ICBT via videoconference is feasible in Japanese patients with bulimia nervosa and binge-eating disorder.

Trial registration: UMIN Clinical Trials Registry UMIN000029426; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033419.

Keywords: binge-eating disorder; bulimia nervosa; cognitive behavioral therapy; internet-based cognitive behavioral therapy; videoconference.

©Sayo Hamatani, Noriko Numata, Kazuki Matsumoto, Chihiro Sutoh, Hanae Ibuki, Keiko Oshiro, Mari Tanaka, Rikukage Setsu, Yohei Kawasaki, Yoshiyuki Hirano, Eiji Shimizu. Originally published in JMIR Formative Research (http://formative.jmir.org), 23.10.2019.