基于互联网的认知行为治疗在降低抑郁症高风险患者的自杀倾向方面的有效性:韩国的一项多中心随机对照试验
Jeong Hun Yang1, C Hyung Keun Park2, Sang Jin Rhee3
1Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Journal of psychiatric research
|December 31, 2024
概括
基于互联网的认知行为疗法 (iCBT) 与通常治疗 (TAU) 相结合,与单独的TAU相比,并没有减少自杀企图. 然而,iCBT + TAU 提供了对自杀念头和抑郁症的短期改善.
科学领域:
- 精神病学是一个精神病学.
- 数字健康数字健康
- 临床心理学 临床心理学
背景情况:
- 大型抑郁症 (MDD) 是全球导致残疾的主要原因.
- 自杀风险是MDD患者的一个关键问题.
- 迫切需要对具有自杀风险的多重抑郁症进行有效的干预.
研究的目的:
- 在患有MDD和自杀风险的患者中,比较基于互联网的认知行为疗法 (iCBT) 加上通常治疗 (TAU) 与单独TAU的有效性.
- 评估对自杀企图,自杀念头,抑郁症状和社会压力的影响.
主要方法:
- 一个多中心的1:1单盲随机受控试验 (RCT) 在韩国的5家三级医院进行.
- 纳入了190名患有MDD和自杀念头或最近自杀企图的患者 (18-44岁).
- 干预包括ICBT (5次4周的会议) +TAU或TAU单独,在基线和6,16,28周进行评估.
主要成果:
- 在ICBT+TAU组 (3次尝试) 和TAU组 (2次尝试) 之间,没有观察到自杀企图数量的显著差异.
- iCBT + TAU 组在自杀念头强度,抑郁症状和社会压力方面显示出明显更快的短期改善.
- 这些短期益处在长期随访 (28周) 时没有持续.
结论:
- 虽然iCBT + TAU没有减少MDD患者的自杀企图,但它提供了暂时的症状缓解.
- 需要进一步的研究,以优化数字干预,以持续有效地管理抑郁症中自杀风险.
- 这些发现突出了iCBT作为辅助疗法的潜力,但强调了需要进行长期结果研究.
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