独立智能手机应用程序对心理健康的有效性:更新的系统审查和元分析
Jennifer K Kulke1, Lukas M Fuhrmann2, Matthias Berking2
1Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany; TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
The Lancet. Digital health
|November 25, 2025
概括
独立的智能手机应用程序显示对抑郁症,焦虑和睡眠问题的有效性,但由于研究质量和异质性适度,结果需要谨慎解释. 当其他治疗方法无法使用时,这些数字工具可以作为可访问的选择.
科学领域:
- 数字心理健康数字心理健康
- 基于证据的干预措施
- 卫生技术评估 卫生技术评估
背景情况:
- 智能手机应用程序提供可访问的心理健康支持,特别是在面对面服务稀缺的地方.
- 以前关于独立心理健康应用程序有效性的证据是不确定的.
- 本次审查涉及评估这些数字工具与非活动控制对比的必要性.
研究的目的:
- 系统地审查和对心理健康的独立智能手机应用程序的随机对照试验 (RCT) 进行元分析.
- 与不活跃的对照组相比,评估这些应用程序的有效性.
- 评估所包含的RCT的质量.
主要方法:
- 在主要数据库 (PubMed,PsycINFO,科学网,Cochrane,Scopus) 进行系统搜索,截至2023年11月10日.
- 包括评价独立心理健康应用程序的RCT在成年人中增加症状严重程度与非活跃对照相比.
- 使用随机效应模型计算效应大小 (Hedges' g) 并评估研究质量和出版偏差.
主要成果:
- 纳入了72个具有21,702名参与者的RCT.
- 对抑郁症 (g=0.45),焦虑 (g=0.35),睡眠问题 (g=0.71),饮食障碍 (g=0.50),PTSD (g=0.15) 和BDD (g=0.86) 发现了显著的影响.
- 对于吸烟,自我伤害,自杀念头或滥用酒精没有观察到任何显著的影响. 对抑郁症和焦虑症的偏见和出版偏见的风险中等至高.
结论:
- 智能手机应用程序显示,对于抑郁,焦虑和睡眠问题,效果大小小至中等.
- 由于异质性和研究质量适度,研究结果应谨慎解释.
- 当第一线治疗无法获得时,可以考虑独立应用程序来治疗抑郁症,焦虑症和睡眠问题.
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