The impact of a 'guided self-help group' on bulimic women: a prospective 15 month study of attenders and non-attenders.

Bulimic women (N = 19) interested in a 'guided self-help group' were assessed by structured interviews and standardized tests. Eleven decided to attend the group, eight did not. Ten attenders (regular attendance of at least 6 months) and five non-attenders were followed for up to 6 months (mail questionnaires) and for 15 months (interviews) respectively. All the attenders and four non-attenders initially fulfilled DSM-III-R criteria for bulimia nervosa. After 15 months five attenders still met these criteria, whereas five improved to the point that they no longer did. Attenders showed significant improvement in specific psychopathology (drive for thinness, bulimia), general psychopathology (depression) and psychosocial adjustment, whereas non-attenders did not. However, three of five non-attenders also improved to a subclinical level, thus reflecting the natural course of the illness. Despite the small sample size our study indicates self-help as a valuable tool in overcoming an eating disorder.