The Clinical Effectiveness of Web-Based Cognitive Behavioral Therapy With Face-to-Face Therapist Support for Depressed Primary Care Patients: Randomized Controlled Trial
The Clinical Effectiveness of Web-Based Cognitive Behavioral Therapy With Face-to-Face Therapist Support for Depressed Primary Care Patients: Randomized Controlled Trial
复制标题
DOI：
10.2196/jmir.2714
复制
发表时间：
2013-08-01
影响因子：
7.4
通讯作者：
Kolstrup, Nils
中科院分区：
文献类型：
--
作者：
Hoifodt, Ragnhild Sorensen;Lillevoll, Kjersti R.;Kolstrup, Nils
背景资料：大多数轻度至中度抑郁症患者在初级保健中接受治疗，但尽管有指南建议，结构化的心理干预很少提供。研究支持基于互联网的抑郁症治疗的有效性;然而，很少有试验研究MoodGYM计划加上治疗师支持的效果。使用这样的干预措施可以改善初级保健的治疗交付。目的：评估轻中度抑郁症的指导性网络干预的有效性和可接受性，这可能适合在全科实践中实施。方法：参与者（N=106）年龄在18岁到65岁之间，从初级保健招募，并随机分配到治疗条件，包括6周的治疗师辅助的基于网络的认知行为治疗（CBT），或延迟6周的治疗条件。干预措施包括挪威版的MoodGYM计划，心理学家的简短面对面支持，以及提醒电子邮件。主要结局指标抑郁症状通过贝克抑郁量表-II（BDI-II）进行测量。次要结局指标包括Beck焦虑量表（BAI）、医院焦虑抑郁量表（HADS）、生活满意度量表（SWLS）和EuroQol组五维自评问卷（EQ-5D）。所有结果均基于自我报告，并在基线，干预后，并在6个月的follow-up.Results：干预后的措施完成了37（71%）和47（87%）的52名参与者在干预和54名参与者在延迟治疗组，分别。线性混合模型分析显示，两组间BDI-II（P= 0.002）、HADS抑郁和焦虑子量表（P
Background: Most patients with mild to moderate depression receive treatment in primary care, but despite guideline recommendations, structured psychological interventions are infrequently delivered. Research supports the effectiveness of Internet-based treatment for depression; however, few trials have studied the effect of the MoodGYM program plus therapist support. The use of such interventions could improve the delivery of treatment in primary care.Objective: To evaluate the effectiveness and acceptability of a guided Web-based intervention for mild to moderate depression, which could be suitable for implementation in general practice.Methods: Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition comprising 6 weeks of therapist-assisted Web-based cognitive behavioral therapy (CBT), or to a 6-week delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, brief face-to-face support from a psychologist, and reminder emails. The primary outcome measure, depression symptoms, was measured by the Beck Depression Inventory-II (BDI-II). Secondary outcome measures included the Beck Anxiety Inventory (BAI), the Hospital Anxiety and Depression Scale (HADS), the Satisfaction with Life Scale (SWLS), and the EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D). All outcomes were based on self-report and were assessed at baseline, postintervention, and at 6-month follow-up.Results: Postintervention measures were completed by 37 (71%) and 47 (87%) of the 52 participants in the intervention and 54 participants in the delayed treatment group, respectively. Linear mixed-models analyses revealed a significant difference in time trends between the groups for the BDI-II, (P=.002), for HADS depression and anxiety subscales (P