Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial
Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial
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DOI：
10.1016/j.invent.2020.100310
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发表时间：
2020-04-01
期刊：
影响因子：
4.3
通讯作者：
Newby, Jill M.
中科院分区：
文献类型：
--
作者：
Kladnitski, Natalie;Smith, Jessica;Newby, Jill M.
目的：与常规护理对照组(TAU)比较，比较跨诊断网络传递认知行为疗法(ICBT)、正念增强型iCBT和独立在线正念训练(TAU)对临床焦虑和抑郁的疗效。方法：在14周的干预期内，将158名被诊断为DSM-5抑郁症和/或焦虑症的患者随机分为三组，分别接受三种临床医生指导的在线干预(TAU)。主要结果是治疗后自我报告的抑郁(PHQ-9)和焦虑(GAD-7)严重程度。次要结果包括依从率、功能障碍(WHODAS-II)、一般痛苦(K-10)和3个月随访时的诊断状态(干预组)。结果：从基线到治疗后和3个月随访，三个方案均显著和较大程度地减少了抑郁(g=0.89-1.53)、焦虑(g=1.04-1.40)和痛苦(g=1.25-1.76)的症状；功能损害(g=0.53-0.98)从基线到治疗后和3个月随访均有中等到较大的减少。意向-治疗线性混合模型显示，三种在线方案在减轻抑郁(g=0.89-1.18)和焦虑(g=1.00-1.23)方面均优于常规护理。结论：跨诊断iCBT、正念增强型iCBT和在线正念训练在治疗抑郁症和焦虑症方面比常规护理更有效，是治疗这些疾病的一种可行的治疗方案。
Aim: To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression.Method: Individuals (N= 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K-10), and diagnostic status at the 3-month follow-up (intervention groups).Results: All three programs achieved significant and large reductions in symptoms of depression (g = 0.89-1.53), anxiety (g = 1.04-1.40), and distress (g = 1.25-1.76); and medium to large reductions in functional impairment (g = 0.53-0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89-1.18) and anxiety (g = 1.00-1.23).Conclusion: Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.