Page 80 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg

80 Chapter 4
Method
In this nonequivalent control group pretest-posttest study, differential (cost-) effectiveness was examined between two cohorts of adult, eating disorder outpatients and inpatients, with a body mass index (BMI: kg /m2) between 12.5 and 17.5. The first cohort received treatment-as-usual (TAU) between July 1, 2012 and December 31, 2014 (N = 75), the second received CBT-E between July 1, 2015 and December 31, 2017 (N = 88), after implementing CBT-E throughout all treatment settings.
Setting and participants
Both cohorts consisted of consecutive referrals by general practitioners or general hospitals to a Dutch routine eating disorder center, which treats patients over 18 on a voluntary basis. All included patients met DSM-IV (American Psychiatric Asso- ciation, 1994) or DSM-5 (American Psychiatric Association, 2013) criteria for anorex- ia nervosa or other specified eating disorder similar to anorexia. Exclusion criteria were immediate medical risk requiring hospitalization in a general hospital, BMI under 12.5, the presence of an interfering psychotic disorder or cognitive impair- ment. In addition, since the intake procedure involves up to three contacts, patients with under four contacts were excluded.
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All procedures involving patients were approved by The Dutch Central Committee on Human Research; informed consent, as part of routine service evaluation, was obtained from all patients.
Assessment
Assessment points were at start and end of treatment. Digital scales were used to measure weight and a wall-mounted stadiometer for height. Eating disorder attitudes and behaviors were measured with the Dutch self-report Eating Disorder Examination- Questionnaire (EDE-Q 6.0; Fairburn & Beglin, 2008), which has good psychometric properties (Aardoom et al., 2012). General psychopathology was measured with the Dutch self-report Depression Anxiety Stress Scale, which has good psychometric properties (DASS-21; Lovibond & Lovibond, 1994; De Beurs et al., 2001). Due to missing data, common in routine settings (Turner et al., 2015), sample sizes vary across some analyses.