在挪威初级保健中针对焦虑和抑郁症的基于互联网的指导治疗:一个随机的非劣势有效性试验
Marit Knapstad1, Otto Robert Smith1,2,3
1Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gt. 7, 5015, Bergen, Norway.
Internet interventions
|February 18, 2026
概括
治疗师指导的基于互联网的认知行为疗法 (iCBT) 没有被发现与焦虑和抑郁症的通常护理无差. 然而,这个iCBT计划显著减少了治疗师的时间,显示出作为有效的心理健康治疗的潜力.
科学领域:
- 心理健康研究 心理健康研究
- 数字治疗学数字治疗学
- 临床心理学 临床心理学
背景情况:
- 分析表明,治疗师指导的基于互联网的认知行为疗法 (iCBT) 的疗效与治疗焦虑和抑郁症的面对面认知行为疗法相当.
- 关于iCBT在常规初级保健环境中的非劣等性,存在有限的检查.
研究的目的:
- 评估"辅助自助" (AS-iCBT) 计划与挪威急诊精神卫生保健 (TAU-PMHC) 中通常的治疗相比的非劣势.
- 评估AS-iCBT对焦虑和轻度至中度抑郁症状的有效性.
主要方法:
- 一个实用,随机控制的非劣等性试验与1:2分配 (AS-iCBT:TAU-PMHC) 涉及390名成年参与者.
- 主要结局包括在六个月的随访期间抑郁症 (PHQ-9) 和焦虑症 (GAD-7) 症状的变化.
- 使用了带有MLR估计器的潜增长曲线模型,应用了d > -0.30的非劣势差额.
主要成果:
- 两组在六个月内都实现了临床显著的症状减少 (PHQ-9和GAD-7).
- AS-iCBT没有满足初级结果的非劣势标准 (PHQ-9:db = -0.11;GAD-7:db = -0.19).
- AS-iCBT表现出可比的客户级联盟,但不是治疗师级联盟,并且需要治疗师时间减少46%左右.
结论:
- 在这种初级保健环境中,AS-iCBT对大多数结果没有满足与常规护理相比的非劣势标准.
- 该AS-iCBT程序显示承诺作为一个资源高效的治疗,减少治疗师的时间,同时产生显著的改善.
- 建议进行进一步的研究,以优化AS-iCBT的实施,特别是与焦虑相关的疾病.
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