Psychological Medicine

Original Articles

A randomized controlled trial of internet-based cognitive-behavioural therapy for bulimia nervosa or related disorders in a student population

V. C. Sánchez-Ortiza1, C. Munroa2, D. Stahla3, J. Housea4, H. Startupa2, J. Treasurea1, C. Williamsa5 and U. Schmidta1 c1

a1 Section of Eating Disorders, Institute of Psychiatry, King's College London, UK

a2 South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK

a3 Department of Biostatistics, Institute of Psychiatry, King's College London, UK

a4 Section of Family Therapy, Institute of Psychiatry, King's College London, UK

a5 Division of Community Based Sciences, Faculty of Medicine, University of Glasgow, UK


Background Bulimic eating disorders are common among female students, yet the majority do not access effective treatment. Internet-based cognitive-behavioural therapy (iCBT) may be able to bridge this gap.

Method Seventy-six students with bulimia nervosa (BN) or eating disorder not otherwise specified (EDNOS) were randomly assigned to immediate iCBT with e-mail support over 3 months or to a 3-month waiting list followed by iCBT [waiting list/delayed treatment control (WL/DTC)]. ED outcomes were assessed with the Eating Disorder Examination (EDE) at baseline, 3 months and 6 months. Other outcomes included depression, anxiety and quality of life.

Results Students who had immediate iCBT showed significantly greater improvements at 3 and 6 months than those receiving WL/DTC in ED and other symptoms.

Conclusions iCBT with e-mail support is efficacious in students with bulimic disorders and has lasting effects.

(Received September 29 2009)

(Revised February 19 2010)

(Accepted March 09 2010)

(Online publication April 21 2010)


c1 Address for correspondence: Professor U. Schmidt, Section of Eating Disorders (PO59), Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email:


† These authors contributed equally to this work.