INTACT · Individually Tailored Stepped Care for Women with Eating Disorders

Final Activity Report Summary - INTACT (Individually Tailored Stepped Care for Women with Eating Disorders)

The Research Training Network INTACT was initiated by 14 experts to improve mental health care for women with eating disorders (ED). 39 young researchers (of whom 24 were employed as Early Stage Researchers through INTACT) participated in the training program. Research was organised in five work packages and results were disseminated through publications (62 papers published or submitted; 14 in preparation; and conference presentations (123 presentations in total). INTACT research generated new insight into the processes of getting ill, getting well, and staying well. The research on the effective use of information and communication technologies (e-mental health) demonstrates the huge potential for the improvement of mental health services. Breakthroughs are exemplified through the research findings described briefly in the following (for more details visit http://www.intact-rtn.eu In a collaborative study between the French and Portuguese partner 151 female university students were observed longitudinally of which 22 (14.6%) developed an ED within a one year observation time. Eating due to emotional distress, preoccupation with food, fear of losing control, social eating and feelings of guilt about eating appear to be the potent risk factors for the development of an ED. There is great concern in the public about the role internet sites and blogs advertising Anorexia and/or Bulimia. In an experimental study including 421 young females, negative effects were found only for participants who already showed a high risk for an ED. They showed negative effects after exposure to pro-ED as well as to pro-recovery blogs. This calls for a thorough reflection. INTACT research opened novel insight into the role of genes for treatment process and outcome of patients with eating disorders. By joining the Genetic Consortium for Anorexia Nervosa (GCAN) INTACT maximised the possibilities for obtaining genetic associations with eating disorders. GCAN was formed in 2007 for this purpose. 4,015 female AN cases have been recruited into the project. In addition, almost 10,000 controls were genotyped from collaborating partners across Europe. Preliminary analysis was performed examining population stratification and initial signals. Cross-disorder mega-analyses to identify genetic variation common to multiple disorders will be conducted (e.g., bipolar disorder and schizophrenia WTCCC samples and the Psychiatric GWAS Consortium). This will open new avenues for personalised care. Longitudinal investigations of the process of improvement/recovery underpin the importance of observed treatment responses, specifically of sudden therapeutic gains. Outcome accumulates over treatment. The findings suggest continuous monitoring of the course of improvement of the individual patient and adjusting treatment focus and intensity to the (changing) actual needs of the individual patient. INTACT partners are among the pioneers in the emerging field of e-mental health. Various versions of internet-delivered care were developed and proved technically feasible, well accepted and showed promising results in studies conducted in Prague, Budapest, and Heidelberg. The Geneva group in collaboration with the company NetUnion at the Lausanne node assessed the efficacy of the Internet-delivered self-help program SALUT for patients with Binge Eating Behavior as well as for those suffering from obesity. The internet-delivered prevention program YoungES[S]PRIT developed by the Heidelberg group proved efficacious in a randomised trial which involved more than 1000 high school students. The risk to develop marked ED symptoms within one year was reduced by nearly 50% for the users of YoungES[S]PRIT compared with the controls. Health economic evaluation confirmed that these novel mental health services can be delivered cost-effectively.

Data: CORDIS, © European Union