基于互联网的认知行为疗法的长期有效性 抑郁症成人自助计划:随机对照试验的系统审查和元分析
Megi Mamukashvili-Delau1,2, Nicole Koburger3, Sandra Dietrich4
1Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany.
JMIR mental health
|August 22, 2023
概括
与对照组相比,基于互联网的认知行为疗法 (iCBT) 自助计划在减少抑郁症症状方面表现出卓越的长期有效性. 这些指导干预措施也显示了随着时间的推移,治疗组内的持续改善.
科学领域:
- 心理健康 心理健康
- 精神病学是一个精神病学.
- 数字健康数字健康
背景情况:
- 抑郁症是一个全球性的心理健康问题,许多人犹不决地寻求药物或心理治疗等传统治疗方法.
- 基于互联网的指导自助计划为抑郁症管理提供了一个有希望的替代方案.
- 虽然短期疗效已经确立,但这些数字干预措施的长期结果需要彻底调查.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),评估基于互联网的认知行为疗法 (iCBT) 自助计划的长期疗效,并提供最少的指导.
- 将ICBT的长期有效性与对照条件进行比较,并评估从治疗后到随访后的群体内改善.
- 根据随访时间进行子组分析并评估对生活质量的影响.
主要方法:
- 进行了对数据库的全面搜索,包括柯克伦协作抑郁症,焦虑症和神经病控制试验登记 (CCDANCTR),灰色文献和参考清单.
- 包括已发表和未发表的RCT报告了基于计算机或ICBT自我帮助抑郁症的长期或随访疗效,每周指导最低 (≤10分钟).
- 该搜索涵盖了2015年至2022年10月期间发表的研究.
主要成果:
- 15项研究 (17个样本) 符合长期分析的纳入标准.
- 在所有随访点上,iCBT干预措施在减少抑郁症症状方面显示出中等效果大小 (SMD -0.43),与对照条件相比.
- 在ICBT组中,随访结果与治疗后的结果相比显著改善 (效果大小小,SMD 0.20),对生活质量 (SMD 0.19) 观察到类似的积极影响.
结论:
- 基于互联网的认知行为疗法 (iCBT) 自助干预措施在与对照组相比,对于患有抑郁症状的个人来说,表现出优越的长期疗效.
- 在随访期间,与在iCBT治疗条件下的治疗后测量相比,观察到减少抑郁症状的统计学显著改善.
- 这些发现支持指导性iCBT抑郁管理自助计划的长期有效性和可持续性.
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