在基于互联网和移动的抑郁症干预中治疗效果的异质性:系统性审查和元分析
Yannik Terhorst1,2, Tim Kaiser3, Eva-Lotta Brakemeier4
1Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany.
JAMA network open
|July 18, 2024
概括
针对抑郁症的基于互联网和移动的干预措施 (IMI) 在轻度病例中没有显著的治疗效果异质性. 然而,个性化,指导数字方法可能会使患有更严重抑郁症状的患者受益.
科学领域:
- 数字健康数字健康
- 心理健康研究 心理健康研究
- 精神病学是一个精神病学.
背景情况:
- 基于互联网和移动的干预 (IMI) 越来越多地用于抑郁症治疗.
- 关于IMI治疗效应 (HTEs) 的异质性的证据有限,这对个性化医学至关重要.
- 了解患者与治疗之间的相互作用可以优化数字心理健康策略.
研究的目的:
- 在IMI中调查抑郁症的HTEs.
- 评估IMI的有效性和有效性.
- 在数字干预中识别影响治疗反应的因素.
主要方法:
- 系统搜索Embase,MEDLINE,Central和PsycINFO的随机临床试验 (RCT) 到2022年3月.
- 包括102个RCT,其中有19758名参与者评估抑郁症严重程度.
- 使用对数方程方差比率 (lnVR) 和Hedges g进行元回归分析来评估HTE和效应大小.
主要成果:
- 在IMI中没有发现HTEs的证据,用于中度抑郁症严重程度 (lnVR = -0.02).
- HTE随着更高的基线抑郁症严重程度 (β̂ = 0.04) 增加.
- 观察到IMI的中等效果大小 (g = -0.56),指导和基线严重程度之间的相互作用.
结论:
- 对于轻度抑郁症中的IMI,没有发现患者与治疗的显著相互作用.
- 个性化,指导数字干预可能对严重抑郁症患者更有益.
- 需要进一步的研究来探索严重抑郁症中IMI的个性化策略.
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