Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT.
Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT.
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DOI：
10.1176/appi.ajp.2017.17010089
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发表时间：
2018-03-01
期刊：
影响因子：
--
通讯作者：
Brown GK
中科院分区：
文献类型：
--
作者：
Thase ME;Wright JH;Eells TD;Barrett MS;Wisniewski SR;Balasubramani GK;McCrone P;Brown GK
与标准CBT相比，评估治疗师支持的计算机辅助认知行为治疗（CCBT）方法的有效性和持久性。在两所大学诊所寻求治疗的154名无药物MDD患者被随机分配到16周的标准CBT（最多20个50分钟的疗程）或使用Good Days Ahead计划的CCBT。CCBT的治疗时间计划是CBT的三分之一。在基线、第8周和第16周以及治疗后3个月和6个月，由独立评分员和自我报告评估结局。疗效的主要检验是第16周时汉密尔顿抑郁量表（HAMD）的非劣效性。大约80%的患者完成了16周方案（CBT：79%; CCBT：82%）。第16周时，CCBT符合非劣效于传统CBT的先验标准。两组在精神病理学的任何测量上都没有显著差异。两组的缓解率也相似（ITT率：41.6%[CBT]，42.9%[CCBT]）。两组在整个随访期间都保持了改善。我们的研究结果表明，将互联网提供的技能建设模块与约5小时的治疗接触相结合的CCBT方法不劣于提供超过8小时额外治疗师接触的传统CBT课程。未来的研究应侧重于传播和优化治疗师的支持方法，以最大限度地提高公共卫生的意义。
To evaluate the efficacy and durability of a therapist-supported method for computer-assisted cognitive-behavior therapy (CCBT) in comparison to standard CBT. 154 drug-free patients with MDD seeking treatment at two university clinics were randomly assigned to either 16 weeks of standard CBT (up to twenty 50-minute sessions) or CCBT using the Good Days Ahead program. The amount of therapist time in CCBT was planned to be about one third that in CBT. Outcomes were assessed by independent raters and self-report at baseline, weeks 8 and 16, and at 3 and 6 months post-treatment. The primary test of efficacy was noninferiority on the Hamilton Rating Scale for Depression (HAMD) at week 16. Approximately 80% of patients completed the 16-week protocol (CBT: 79%; CCBT: 82%). CCBT met a priori criteria for noninferiority to conventional CBT at week 16. The groups did not differ significantly on any measure of psychopathology. Remission rates also were similar for the two groups (ITT rates: 41.6%[CBT], 42.9%[CCBT]). Both groups maintained improvements throughout the follow-up. Our findings indicate that a method of CCBT that blends internet-delivered skill-building modules with about 5 hours of therapeutic contact was noninferior to a conventional course of CBT that provided over 8 hours of additional therapist contact. Future studies should focus on dissemination and optimizing therapist support methods to maximize public health significance.
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影响因子：
6.6
作者：
Andersson, Gerhard;Hesser, Hugo;Carlbring, Per
通讯作者：
Carlbring, Per
影响因子：
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作者：
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作者：
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Epperson, C. Neill
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作者：
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通讯作者：
Gallop, R
影响因子：
7.4
作者：
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通讯作者：
Kolstrup, Nils