A Multimedia Program to Prevent Depression Relapse

描述（由申请人提供）：重度抑郁症是困扰成年人的最普遍的精神障碍之一。它严重影响角色功能，通常会反复发作。尽管抗抑郁药物已被证明有效，并且是治疗抑郁症最常见的方法，但高达70%的成年人没有完成推荐的治疗方案。也有证据表明，在预防抑郁症复发方面，认知行为疗法结合药物治疗比单独药物治疗更有效。该项目将开发和测试一种交互式多媒体干预，旨在提高接受抗抑郁药物的门诊患者对治疗方案的依从性，防止抑郁症复发。经过经验验证的框架将适用于通过互联网或CD-ROM进行的自我管理。干预将包括以知识和技能为基础的模块，包括：理解抑郁症、坚持治疗方案、情绪监测、行为激活、认知重构、人际关系、放松和未来规划。以能力为基础的教学设计将采用基于视频的教程、推荐和行为建模小片段来组织多个会议。第一阶段的原型以女性为目标，包括理解抑郁症、坚持治疗方案、情绪监测和行为激活等模块，将在一项随机试验中进行评估。在第二阶段，将开发所有八个模块，针对六个性别和年龄组，并在随机试验中进行评估。

DESCRIPTION (provided by applicant): Major depression is one of the most prevalent mental disorders to afflict adults. It seriously impacts role functioning and typically takes a recurrent course. Although antidepressant medications have proven efficacy and are the most common treatment for depression, up to 70% of adults do not complete the recommended regimen. There is also evidence that cognitive-behavioral therapy in conjunction with medications is more effective than medications alone in preventing depression relapse. This project will develop and test an interactive multimedia intervention aimed at improving regimen adherence and preventing depression relapse for outpatients receiving antidepressants. Empirically validated frameworks will be adapted for self-administration via the Internet or CD-ROM. The intervention will consist of knowledge- and skills-based modules including: understanding depression, regimen adherence, mood monitoring, behavioral activation, cognitive restructuring, interpersonal relations, relaxation, and planning for the future. The competency-based instructional design will be structured for multiple sessions using video-based tutorials, testimonials, and behavior modeling vignettes. The Phase I prototype, targeted to women, with modules on understanding depression, regimen adherence, mood monitoring, and behavioral activation will be evaluated in a randomized trial. In Phase II, all eight modules will be developed, targeted to six gender and age groups, and evaluated in a randomized trial.