Page 60 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg

60 Chapter 3
Measures
Patients completed self-report measures as part of routine practice at start and end-of-treatment (EOT). Since, as is common in routine settings (Turner et al., 2015), a proportion of the data were not collected, numbers vary across some analyses (see tables 1,2,3). The Dutch Eating Disorders Examination-Questionnaire (EDE-Q 6.0; Fairburn & Beglin, 2008; Aardoom, Dingemans, Slof op ‘t Landt, & Van Furth, 2012) has good psychometric properties and was used to asses eating disorder pathology. General psychiatric symptomatology was assessed using the Dutch Depression Anxi- ety and Stress Scale which has good psychometric properties (DASS-21; Lovibond & Lovibond, 1994; De Beurs, Van Dyck, Marquenie, Lange, & Blonk, 2001).
The effect measure for the cost-effectiveness analysis was the proportion of patients with an EDE-Q global score under one standard deviation (SD) above community mean, that is, below 2.77 (UK norms).
Intervention
TAU during July 1, 2012 - December 31, 2014
TAU was based on an eclectic approach of cognitive and behavioral interventions, psychoeducation, dietary advice, schema therapy and psychomotor inventions. TAU was delivered in inpatient units, daycare units and in an outpatient unit where treat- ment was delivered either individually or in groups. Treatment duration was not fixed and differed considerably between therapists and units. Underweight inpa- tients could be hospitalized until they reached healthy weight. In the day care units, patients were treated either after being hospitalized or when outpatient treatment was assumed to be insufficient.
CBT-E during July 1, 2015- December 31, 2017
CBT-E is a time limited, individually based treatment. In the outpatient setting, the focused form of CBT-E, a 20-sessions treatment over a 20 week period, was offered. For underweight patients the number of sessions can extend up to 40, or in certain cases slightly more, depending on the degree of underweight, consistent with CBT-E guidelines (Fairburn, 2008). Following CBT-E principles, weight regain can be achieved during outpatient treatment. Accordingly, the primary goal of hospitaliza- tion is making patients psychiatrically and somatically stable enough to profit from outpatient treatment (Dalle Grave, Bohn, Hawker & Fairburn, 2008). When patients are stable, outpatient CBT-E starts. By consequence, the duration of the inpatient