A Multimedia Program to Prevent Depression Relapse

描述（由申请人提供）：重度抑郁症是折磨成年人的最普遍的精神障碍之一。它严重影响角色功能，通常需要一个周期性的过程。虽然抗抑郁药物已被证明有效，并且是抑郁症最常见的治疗方法，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，认知行为疗法与药物相结合，在预防抑郁症复发方面比单独使用药物更有效。该项目将开发和测试一种交互式多媒体干预，旨在改善接受抗抑郁药的门诊患者的治疗方案依从性和预防抑郁症复发。经验验证的框架将通过互联网或CD-ROM进行自我管理。干预将包括基于知识和技能的模块，包括：了解抑郁症，坚持治疗方案，情绪监测，行为激活，认知重建，人际关系，放松和规划未来。基于能力的教学设计将使用基于视频的教程，推荐和行为建模小插曲的多个会话的结构。第一阶段的原型，针对妇女，与模块的理解抑郁症，坚持养生，情绪监测和行为激活将在一项随机试验中进行评估。在第二阶段，将针对六个性别和年龄组开发所有八个模块，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.