Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression
Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression
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DOI：
10.1016/j.jad.2013.08.022
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发表时间：
2013-12-01
影响因子：
6.6
通讯作者：
Carlbring, Per
中科院分区：
文献类型：
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作者：
Andersson, Gerhard;Hesser, Hugo;Carlbring, Per
背景资料：指导性互联网认知行为疗法（ICBT）已被发现对轻度至中度抑郁症的治疗有效，但与更成熟的基于群体的CBT没有直接的比较，并进行了长期随访。方法：从普通人群中招募轻度至中度抑郁的参与者，并随机分配至指导性ICBT（n =33）或现场组治疗（n=36）。在干预前后完成了评估抑郁、焦虑和生活质量的措施。在治疗结束后一年和三年进行随访。结果如下：数据进行了分析意向治疗的基础上，使用线性混合效应回归analysis.Results的自评版本的蒙哥马利-阿斯伯格抑郁量表显示，在两个组的显着改善，在整个时间表明非劣效性的指导ICBT，甚至有一种倾向，指导ICBT组是上级组为基础的CBT在三年的后续行动。治疗后ICBT条件的组内效应量显示Cohen d=1.46，3年随访时具有类似的大效应，d=1.78。对于CBT组内相应的组内效应分别为d =0.99和d=1.34，分别。局限性：该研究是小的两个积极的治疗，并没有安慰剂或可信的控制conditions.Conclusions：指导ICBT至少是有效的基于组的CBT和长期的影响，可以持续到3年治疗后。(C)2013爱思唯尔有限公司版权所有。
Background: Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.Method: Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n =33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended. Results: Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis.Results on the self-rated version of the Montgomery-Asberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post treatment showed a Cohen's d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within group effects were d =0.99 and d=1.34, respectively.Limitations: The study was small with two active treatments and there was no placebo or credible control condition.Conclusions: Guided ICBT is at least as effective as group based CBT and long-term effects can be sustained up to 3 years after treatment. (C) 2013 Elsevier B.V. All rights reserved.