Randomized Controlled Trial of SuperBetter, a Smartphone-Based/Internet-Based Self-Help Tool to Reduce Depressive Symptoms
Randomized Controlled Trial of SuperBetter, a Smartphone-Based/Internet-Based Self-Help Tool to Reduce Depressive Symptoms
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DOI：
10.1089/g4h.2014.0046
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发表时间：
2015-06-01
影响因子：
3.5
通讯作者：
Maxwell, Bez
中科院分区：
文献类型：
--
作者：
Roepke, Ann Marie;Jaffee, Sara R.;Maxwell, Bez
目的：科技的进步激发了针对抑郁症患者的基于电脑和智能手机的自助项目的发展，但这些项目的效果尚不确定。这项随机对照试验评估了一项名为SuperBetter （SB）的干预措施，该干预措施可通过智能手机和/或SB网站访问。材料和方法：根据流行病学研究中心抑郁问卷（CES-D），我们在网上招募了283名有明显抑郁症状的成年iPhone (R) （Apple, Cupertino， CA）用户。他们被随机分配到三种情况之一：(a)使用认知行为疗法和积极心理治疗策略的SB版本（CBT-PPT SB）；(b)侧重于自尊和接受的一般SB版本（一般SB）；或(c)轮候册对照组。两个SB组被要求每天使用SB 10分钟，持续1个月。通过随访，所有参与者每两周在线完成一次心理困扰和幸福感测量。意向治疗分析使用层次线性模型进行。结果：正如假设的那样，通过后测（Cohen’s d = 0.67）和随访（d = 1.05）， SB参与者的CES-D分数比WL参与者下降得更大。与预测相反的是，CBT-PPT合成合成并不比一般合成合成好；两种版本的SB均比WL更有效。不同SB版本间的差异倾向于一般SB，但没有统计学意义。结论：考虑到高流失率和有动机的、自我选择的样本，应该谨慎地解释这些大的效应值。尽管如此，基于智能手机/互联网的自助可能在治疗抑郁症方面发挥重要作用。
Objective: Technological advances have sparked the development of computer-and smartphone-based self-help programs for depressed people, but these programs' efficacy is uncertain. This randomized controlled trial evaluated an intervention called SuperBetter (SB), which is accessed via smartphone and/or the SB Web site.Materials and Methods: Online, we recruited 283 adult iPhone (R) (Apple, Cupertino, CA) users with significant depression symptoms according to the Center for Epidemiological Studies Depression questionnaire (CES-D). They were randomly assigned to one of three conditions: (a) a version of SB using cognitive-behavioral therapy and positive psychotherapy strategies to target depression (CBT-PPT SB); (b) a general SB version focused on self-esteem and acceptance (General SB); or (c) a waiting list control group (WL). The two SB groups were instructed to use SB for 10 minutes daily for 1 month. All participants completed psychological distress and well-being measures online every 2 weeks through follow-up. An intent-to-treat analysis was conducted using hierarchical linear modeling.Results: As hypothesized, SB participants achieved greater reductions in CES-D scores than WL participants by posttest (Cohen's d = 0.67) and by follow-up (d = 1.05). Contrary to prediction, CBT-PPT SB did not perform better than General SB; both versions of SB were more effective than the WL control. Differences between SB versions favored General SB but were not statistically significant.Conclusions: These large effect sizes should be interpreted cautiously in light of high attrition rates and the motivated, self-selected sample. Nonetheless, smartphone-based/Internet-based self-help may play an important role in treating depression.