A feasibility trial of an Internet-delivered and transdiagnostic cognitive behavioral therapy treatment program for anxiety, depression, and disability among adults with epilepsy
A feasibility trial of an Internet-delivered and transdiagnostic cognitive behavioral therapy treatment program for anxiety, depression, and disability among adults with epilepsy
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DOI：
10.1111/epi.13569
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发表时间：
2016-11-01
期刊：
影响因子：
5.6
通讯作者：
Dear, Blake F.
中科院分区：
文献类型：
--
作者：
Gandy, Milena;Karin, Eyal;Dear, Blake F.
焦虑和抑郁在癫痫患者（PWE）中非常普遍，并导致残疾增加。不幸的是，存在许多障碍（例如，成本，距离和耻辱）和服务差距（例如，缺乏服务和训练有素的临床医生），这阻止了许多PWE获得传统的面对面心理服务。本研究的目的是探讨一个新的transdiagnosis互联网提供的认知行为治疗（iCBT）程序，慢性疾病的过程中，同时治疗焦虑，抑郁和disability.MethodsA单组可行性开放试验的可行性，涉及27名成年癫痫患者。该计划包括五个在线课程提供超过8周，并提供每周从心理健康专业人士通过电子邮件和电话。ResultsHigh治疗完成率和满意度的报告。我们的主要结局有显著改善的证据（组内科恩d [d];平均[平均]焦虑（d 1.28; avg.减少54%）、抑郁（d1.24; avg.减少54%）、癫痫特异性抑郁（d 0.95; avg.减少35%）和残疾（d 0.62;平均减少33%），并在3个月随访时持续或进一步改善。在我们的次要结局中，生活满意度有显著改善（d 0.70;平均值）。改善26%），但没有知觉的认知困难（D 0.48;平均值。减少15%）。突出的潜力的方法，相对较少的临床医生的时间，需要每个参与者（平均80.62分钟，标准差[SD] 54.78），和试验涉及广泛的地理分散patients.SignificanceThe目前的研究结果支持的可行性和潜力transdiagnosis互联网提供治疗成人癫痫。进一步的大规模对照试验是必要的。
ObjectiveAnxiety and depression are highly prevalent in people with epilepsy (PWE) and contribute to increased disability. Unfortunately, there are numerous barriers (e.g., cost, distance, and stigma) and service gaps (e.g., lack of services and trained clinicians) that prevent many PWE from accessing traditional face-to-face psychological services. The aim of the present study was to examine the feasibility of a new transdiagnostic Internet-delivered cognitive behavioral therapy (iCBT) program, the Chronic Conditions Course, to simultaneously treat symptoms of anxiety, depression, and disability.MethodsA single-group feasibility open trial was employed involving 27 adults with epilepsy. The program comprises five online lessons delivered over 8 weeks and is provided with weekly contact from a mental health professional via e-mail and telephone.ResultsHigh treatment completion rates and levels of satisfaction were reported. Evidence of significant improvements in our primary outcomes (within-group Cohen's d [d]; average [avg.] reductions) of anxiety (d 1.28; avg. reduction 54%), depression (d 1.24; avg. reduction 54%), epilepsy-specific depression (d 0.95; avg. reduction 35%), and disability (d 0.62; avg. reduction 33%) were observed at posttreatment, which were sustained at or further improved to 3-month follow-up. On our secondary outcomes there were significant improvements for life satisfaction (d 0.70; avg. improvement 26%) but not for perceived cognitive difficulties (d 0.48; avg. reduction 15%). Highlighting the potential of the approach, relatively little clinician time was required per participant (mean 80.62 min, standard deviation [SD] 54.78), and the trial involved a broad range of geographically dispersed patients.SignificanceThe findings of the current study support the feasibility and potential of transdiagnostic Internet-delivered treatments for adults with epilepsy. Further large-scale controlled trials are warranted.