改善对强迫症障碍的无指导互联网治疗的坚持:一个随机对照试验
Lena Jelinek1, Johanna Schröder2, Lara Bücker1
1Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Journal of affective disorders
|June 22, 2023
概括
针对强迫症 (OCD) 的基于互联网的认知行为疗法 (iCBT) 显示出有效性. 固定的模块顺序可能会提高强迫症症状的减少与自由选择顺序相比,尽管类似的坚持.
科学领域:
- 精神病学和行为科学
- 数字健康数字健康
- 临床心理学 临床心理学
背景情况:
- 基于互联网的认知行为疗法 (iCBT) 的低坚持可能会限制其对强迫症 (OCD) 的有效性.
- 模块自主性 (自由选择与固定顺序) 是影响iCBT遵守和结果的潜在因素.
研究的目的:
- 调查未经指导的iCBT中模块自主性的变化是否会影响强迫症的坚持和治疗效果.
- 为了比较固定模块顺序 (iCBTfixed) 与强迫症自由选择模块顺序 (iCBTfree+) 的疗效.
主要方法:
- 151名强迫症患者被随机分配到iCBT固定或iCBTfree+.
- 在基线,8周和16周评估的结果包括强迫症严重程度 (Y-BOCS),坚持度指标,抑郁症,自尊和满意度.
- 进行了治疗意图 (ITT) 和完整病例 (CC) 分析.
主要成果:
- 两种iCBT方案都显著降低了强迫症的严重程度.
- 完整的病例分析表明,从基线到8周 (中等效果大小) 的iCBTfixed组与iCBTfree+相比,iCBTfixed组的强迫症严重程度和生活质量得到了更大的改善.
- 两组之间没有观察到坚持 (利用时间,完成模块) 的显著差异.
结论:
- 无指导的iCBT有效改善强迫症症状.
- 一个固定的模块顺序可以提供优越的治疗效果强迫症比一个自由选择的顺序,即使与相似的坚持.
- 需要进行进一步的研究,以了解强迫症iCBT的坚持和结果之间的关系.
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