Single-Session Mobile-Augmented Intervention in Serious Mental Illness: A Three-Arm Randomized Controlled Trial
Single-Session Mobile-Augmented Intervention in Serious Mental Illness: A Three-Arm Randomized Controlled Trial
复制标题
DOI：
10.1093/schbul/sby135
复制
发表时间：
2019-07-01
影响因子：
6.6
通讯作者：
Granholm, Eric L.
中科院分区：
文献类型：
--
作者：
Depp, Colin A.;Perivoliotis, Dimitri;Granholm, Eric L.
对严重精神疾病的心理社会干预是资源密集型的，而且很难获得。通过后续自动化移动的健康干预增强的简短干预（例如，单次治疗）可能会扩大治疗的可及性。这是一项随机单盲对照试验，共有255名被诊断为精神分裂症或双相情感障碍的患者参加。参与者被随机分配到三种条件之一：CBT 2go，将一个单独的认知行为治疗与通过移动的设备提供的自动思维挑战/适应行为相结合;自我监测（SM），将单次疾病心理教育与症状自我监测相结合;和照常治疗（TAU）。参与者在基线、6周（中点）、12周（治疗后）和24周（随访）进行评估，主要结果是总体精神病理学（简明精神病评定量表扩展版（BPRS-24 D）），次要结果是社区功能（特定功能水平; SLOF）和失败主义表现信念（DPB）。我们还收集了不良事件的数据。对主要结局（BPRS总分）的结局分析表明，两种活动性条件（CBT 2go和SM）相对于TAU的组间相互作用时间（0-24周）显著但适度改善。CBT 2go的作用与SM没有差异。在24周内，CBT 2go中存在显著的时间x组相互作用，SLOF评分更好，但SM中没有。对DPB无时间-组效应。在CBT 2go条件下DPB减少，但在SM中不减少。这些结果表明，通过移动的干预增强的单一干预是可行的，并且与常规护理相比，对整体精神病理学和社区功能（包括CBT）的影响较小但持续。
Psychosocial interventions for serious mental illness are resource intensive and poorly accessible. Brief interventions (eg, single session) that are augmented by follow-on automated mobile health intervention may expand treatment access. This was a randomized single blind controlled trial with 255 individuals diagnosed with schizophrenia or bipolar disorder. Participants were randomized to one of three conditions: CBT2go, which combined one individual session of cognitive behavioral therapy with automated thought challenging/adaptive behavior delivered through mobile devices; Self Monitoring (SM), which combined single-session illness psychoeducation with self-monitoring of symptoms; and treatment-as-usual (TAU). Participants were assessed at baseline, 6 weeks (midpoint), 12 weeks (posttreatment), and 24 weeks (follow up) with our primary outcome global psychopathology (Brief Psychiatric Rating Scale-expanded version (BPRS-24D, and secondary outcomes community functioning (Specific Level of Function; SLOF) and defeatist performance beliefs (DPBs). We also collected data on adverse events. Outcome analyses on the primary outcome, BPRS Total score, indicated a significant time (0-24 wk) by group interaction with significant but modest improvement comparing two active conditions (CBT2go and SM) relative to TAU. Effects of CBT2go were not different from SM. There was a significant time x group interaction with better SLOF scores in CBT2go across 24 weeks, but not in SM. There were no time-by-group effects on DPBs. DPBs decreased in the CBT2go condition but not in SM. These results indicated that single intervention augmented by mobile intervention was feasible and associated with small yet sustained effects on global psychopathology and, when inclusive of CBT, community function compared with usual care.