基于互联网的长期有效性与传统的认知行为疗法在精神疾病中的长期有效性:系统性审查和元分析
Rūta Bakanaitė1, Indrė Bakanienė2, Ava Kanyeredzi3
1Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
概括
通过互联网提供的认知行为疗法 (iCBT) 显示了与面对面的CBT相比的长期有效性. 然而,ICBT的学率更高,特别是在自导形式,这表明需要治疗师的支持.
科学领域:
- 心理健康 心理健康
- 精神病学是一个精神病学.
- 数字治疗学数字治疗学
背景情况:
- 互联网交付的认知行为疗法 (iCBT) 是一个不断增长的替代传统面对面的CBT.
- 在各种精神疾病中,ICBT的长期有效性需要进一步研究.
- 了解iCBT的比较结果和最佳应用是至关重要的.
研究的目的:
- 系统地比较iCBT与面对面CBT的长期有效性.
- 为了确定从iCBT中受益最多的精神疾病.
- 分析iCBT和传统CBT之间的坚持率.
主要方法:
- 在主要数据库 (PubMed,Embase,PsycINFO等) 的系统文献搜索. 最长时间为2025年5月.
- 包括随机对照试验 (RCT),比较长期ICBT和面对面的CBT对抑郁,焦虑和饮食障碍.
- 使用随机效应模型进行元分析,以确定标准化平均差异 (赫奇斯的g) 和基平方测试的依从性.
主要成果:
- 分析了11个涉及1272名参与者的RCT.
- 在ICBT和面对面CBT之间没有发现显著的长期疗效差异 (Hedges' g = -0.07).
- 抑郁症患者对ICBT的反应最好;焦虑症患者的结果不尽相同;饮食障碍患者的结果不太好. 与面对面CBT (86.68%) 相比,iCBT的坚持率较低 (70.06%),但随着治疗师的指导 (79.09%) 改善.
结论:
- iCBT是一种可行的长期治疗,可以替代传统的CBT.
- 在ICBT中,特别是未经指导的格式中,放弃率更高,突显了治疗师支持坚持坚持的重要性.
- 未来的研究应该专注于优化iCBT交付,定制干预措施,并加强参与者的参与.
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