Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial.
Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial.
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DOI：
10.2196/jmir.3261
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发表时间：
2014-05-29
影响因子：
7.4
通讯作者：
Riper H
中科院分区：
文献类型：
--
作者：
Kramer J;Conijn B;Oijevaar P;Riper H
高达9%的年轻人患有抑郁症。不幸的是，许多需要帮助的人仍然得不到治疗。互联网提供匿名的方式来帮助抑郁的年轻人，特别是那些因为害怕耻辱而不愿意寻求帮助的人。我们的目标是通过将其与等待名单对照组进行比较，评估基于解决方案集中简短疗法（SFBT）的个人聊天治疗对12-22岁患有抑郁症状的年轻人的有效性。在这项研究中，263名有抑郁症状的年轻人被随机分配到基于网络的SFBT干预，PratenOnline或等待列表控制条件。聊天治疗是由训练有素的专业人士提供的。在9周和4.5个月后，通过流行病学研究中心抑郁量表（CES-D）对两组进行抑郁投诉的比较。仅针对聊天组，探索基线后7.5个月时抑郁症状的变化。实验SFBT条件（n=131）在9周和4.5个月的CES-D上显示出比等候名单条件（n=132）显著更大的抑郁症状改善，9周时组间效应量较小（d=0.18，95% CI -0.10至0.47），4.5个月时的效应量较大（d=0.79，95% CI 0.45-1.08）。仅在4.5个月时，SFBT干预组显示抑郁症发生可靠且临床显著变化的参与者百分比显著更大（28.2% vs 11.4%，等待名单，P<0.001，需要治疗的人数=6）。在7.5个月时，SFBT组显示出进一步的改善。然而，由于减员率很高，必须认真考虑结果。PratenOnline基于网络的SFBT聊天干预在减少抑郁症状方面比等待名单对照组更有效，并且在随访时的效果比治疗后更大。需要更多的研究来确定结果是否会被复制，特别是对于那些年龄小于18岁的人。荷兰试验注册处：NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp? TC=1696（WebCite存档，网址：http：//www.webcitation.org/6DspeYellow J）。
Up to 9% of young people suffer from depression. Unfortunately, many in need of help remain untreated. The Internet offers anonymous ways to help depressed youth, especially those who are reluctant to search for help because of fear of stigma. Our goal was to evaluate the effectiveness of an individual chat treatment based on Solution-Focused Brief Therapy (SFBT) to young individuals aged 12-22 years with depressive symptoms by comparing it to a waiting list control group. For this study, 263 young people with depressive symptoms were randomized to the Web-based SFBT intervention, PratenOnline, or to a waiting list control condition. The chat treatment was delivered by trained professionals. Groups were compared on depressive complaints as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) after 9 weeks and 4.5 months. For the chat group only, changes in depressive symptoms at 7.5 months after baseline were explored. The experimental SFBT condition (n=131) showed significantly greater improvement than the waiting list condition (n=132) in depressive symptoms at 9 weeks and 4.5 months on the CES-D, with a small between group effect size at 9 weeks (d=0.18, 95% CI -0.10 to 0.47) and a large effect size at 4.5 months (d=0.79, 95% CI 0.45-1.08). The percentage of participants showing a reliable and clinically significant change in depression was significantly larger for the SFBT intervention at 4.5 months only (28.2% vs 11.4% for the waiting list, P<.001, number needed to treat=6). At 7.5 months, the SFBT group showed further improvements. However, results have to be considered carefully because of high attrition rates. The Web-based SFBT chat intervention of PratenOnline was more effective than a waiting list control group in reducing depressive symptoms, and effects were larger at follow-up then at post-treatment. More studies are needed to find out if outcomes will be replicated, especially for those younger than 18 year old. Netherlands Trial Register: NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696 (Archived by WebCite at http://www.webcitation.org/6DspeYWrJ).
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