臨界下抑うつ症の成人の重大うつ病予防のためのウェブベースのガイドされた自助介入の効果:ランダム化臨床試験
Claudia Buntrock1, David Daniel Ebert2, Dirk Lehr3
1Division of Online Health Training, Innovation Incubator, Leuphana University Lueneburg, Germany2Department of Clinical Psychology, EMGO+ Institute for Health and Care Research, VU University, Amsterdam, the Netherlands.
JAMA
|May 4, 2016
まとめ
ウェブベースのガイドされた自助介入は,12ヶ月間にわたり,抑うつ症の成人におけるメジャーうつ病 (MDD) の発生率を著しく減少させました. この予防戦略は うつ病の管理に 有望なアプローチを示しています
科学分野:
- 精神 的 な 健康
- 臨床心理学
- デジタル・ヘルス
背景:
- 重度のうつ病 (MDD) の治療は,機能的および健康的な結果の改善に限られた成功を収めています.
- MDDの予防は 重要な公衆衛生の目標として注目されています
研究 の 目的:
- MDDを予防するためのウェブベースのガイド付き自助介入の有効性を評価する.
- リスクのある個人における重度のうつ病の発症に対するデジタル介入の影響を評価する.
主な方法:
- 臨界以下うつ病の成人406人を対象とした2つのグループによるランダム化臨床試験
- 参加者は,ウェブベースのガイドされた自己支援介入 (オンラインサポートによる認知行動療法と問題解決療法) またはウェブベースの精神教育プログラムを受講しました.
- 主なアウトカムは,構造化された臨床面接を通じて評価された12ヶ月のフォローアップ期間におけるMDD発症までの時間でした.
主要な成果:
- ウェブベースのガイデッドセルフヘルプ介入群は,コントロール群 (41%) と比較して12ヶ月でMDDの発生率が著しく低下しました.
- コックス回帰分析では,MDDの発症リスクの低下を示した0. 59 (95%CI,0. 42- 0. 82;P=. 002) の危険比率が示された.
- 新しいMDDの症例を予防するために必要な治療数は5. 9でした.
結論:
- ウェブベースのガイド付きの自己援助介入は,重度のうつ病の発生率を効果的に減らすことができます.
- このデジタルメンタルヘルス介入は MDDの予防戦略としての可能性を 示しています
- オンラインのサポートなしで一般化と有効性を調べるためにさらなる研究が必要である.
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