对于自杀风险较高的住院患者的数字治疗干预:一项随机临床试验
Craig J Bryan1, Patricia Simon2,3, Samuel T Wilkinson2
1Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus.
JAMA network open
|August 8, 2025
概括
提供认知行为治疗 (CBT) 的智能手机应用程序并没有减少住院患者首次自杀企图的时间. 然而,它持续减少了自杀念头,并降低了那些先前有过自杀企图的人的重复尝试.
科学领域:
- 数字治疗学数字治疗学
- 精神病学是一个精神病学.
- 自杀学是一种自杀学.
背景情况:
- 自杀在美国是一个重大的公共卫生问题,需要有效的干预措施.
- 针对自杀的认知行为疗法 (CBT) 是有效的,但面临实施挑战.
- 数字治疗干预提供了一个可扩展的解决方案,用于为预防自杀提供CBT.
研究的目的:
- 为了评估基于智能手机的数字治疗方法的有效性,提供以自杀为重点的CBT.
- 评估干预措施对减少住院患者的自杀行为的影响.
- 在一项随机临床试验中,将数字治疗与对照应用进行比较.
主要方法:
- 多站点,双盲,随机临床试验,涉及339名自杀风险较高的成年住院患者.
- 参与者接受了数字治疗干预或对照应用程序,以及通常的治疗.
- 主要终点:到第一个实际自杀企图的时间;次要终点:自杀想法,临床改善.
主要成果:
- 数字疗法并没有显著改变第一次自杀企图的时间.
- 在之前有过自杀企图的患者中,数字治疗组显示后续自杀企图率降低了58.3%.
- 数字治疗组经历了持续减少自杀想法和更高的临床改善率.
结论:
- 基于智能手机的数字治疗干预没有达到其减少第一次自杀未遂的时间的主要终点.
- 该干预表明,在特定的患者小组中,有潜力持续减少自杀念头和减少反复发生的自杀企图.
- 研究结果表明,数字治疗可能对有过自杀未遂病史的患者有益,需要进一步调查.
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