Instagram Intervention for Mental Health (IIMH): approximation to social media in the treatment of anorexia nervosa: a randomized, controlled, open, pragmatic and multicenter clinical trial

Abstract

INTRODUCTION: Anorexia Nervosa (AN) is a mental disorder classified in the group of Eating Disorders, defined above all by disturbances in eating linked to an uncontrollable wish of being thin, that does not diminish despite progressive thinness and the danger this implies to mental and physical integrity. It affects overall women in adolescent age, and it has a high number of complications and the highest mortality rate of all mental illnesses. It’s considered a multifactorial disorder, influenced and caused by biological, personality, family, social and cultural factors. The treatment is psychotherapeutic and it has a good level of evidence supporting it, but still a high percentage of cases become chronic, with the serious impairments linked to this. We propose a complementary intervention simultaneous to psychotherapy, for those adolescent patients that finish a hospitalization period due to the disorder. We take advantage of the prevalent use of social media platforms in this age period to develop an intervention through the platform of Instagram, used by more than a 90% of adolescents nowadays. HYPOTHESIS: Patients exposed to the Instagram Intervention for Mental Health (IIMH), complementary to the ambulatory psychotherapeutic TAU program that is applied when leaving a hospital admission due to AN disorder result in a better outcome compared to TAU alone. Primary efficacy variable of the study will be Body Mass Index (BMI). OBJECTIVES: The main aim of this study is to assess the efficacy of the IIMH in combination with outpatient psychotherapy TAU in BMI outcome, relative application of outpatient psychotherapy TAU alone, for AN after inpatient treatment. Secondary objectives are to assess efficacy of this intervention in AN psychopathologic specific symptoms and other associated, like anxiety, depression, and body shape disturbance. METHODS: We will perform an open, controlled, randomized, pragmatic and multicenter clinical trial with two treatment groups: one receiving outpatient TAU and the other receiving outpatient TAU + our Instagram-based intervention. This Instagram Intervention for Mental Health (IIMH) will be conducted by an expert therapist and will include complementary and evidence-supported elements for the Treatment as Usual (TAU) like social promote thin-ideal model criticize, feminism and social gender deconstruction discussion and AN recovery experiences information, all carried out in a dynamic motivational group. The IIMH will last for 6 months, after what we will pick up the results and analyze it