2/2-Computer-Assisted Cognitive-Behavior Therapy for Depression

2/2-计算机辅助抑郁症认知行为疗法

• 批准号: 8427392
• 负责人: Jesse H. Wright
• 金额: $ 24.43万
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-16 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8427392
• 关键词: Acute; Attitude; Characteristics; Clinical; Cognitive; Cognitive Therapy; Computer Assisted; Computer-Assisted Therapy; Control Groups; DSM-IV; Data; Data Analyses; Development; Disease remission; Elements; Female; Grant; Health Care Costs; Hour; Individual; Intervention; Investigation; Knowledge; Major Depressive Disorder; Measures; Mental Depression; Methods; Modeling; Multimedia; Outcome; Outpatients; Patient Preferences; Patients; Pennsylvania; Phase; Protocols documentation; Psychotherapy; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recruitment Activity; Relapse; Research; Research Design; Research Methodology; Sampling; Services; Site; Social Functioning; Staging; Testing; Therapeutic; Thinking; Time; Training; Treatment outcome; Universities; Waiting Lists; base; behavior change; clinically significant; comparative efficacy; conventional therapy; cost; cost effective; cost effectiveness; depressive symptoms; design; effective therapy; efficacy testing; experience; follow-up; health care service utilization; improved; male; meetings; programs; public health relevance; response

DESCRIPTION (provided by applicant): We propose a two center, randomized controlled trial evaluating the efficacy and cost-effectiveness of computer-assisted cognitive-behavior therapy (CCBT) for outpatients with major depressive disorder (MDD). Results of a preliminary study indicated that, despite reducing the amount of therapist contact by about 50%, CCBT was at least as effective as an 8 week course of conventional individual CBT on depression outcomes, with greater effects on dysfunctional attitudes and knowledge about CBT. We now propose to conduct a more rigorous test of the therapeutic equivalence and cost-effectiveness of CCBT versus a full 16 week, 20 session course of individual CBT, which provides three times the amount of therapeutic contact. A total of 172 male and female outpatients (86 per site) meeting SCID/DSM-IV criteria for MDD will be randomized across five years. Outcomes will be assessed by independent evaluators without knowledge of the treatment received. The study is designed to have the statistical power to test the equivalence of CCBT and the full course of CBT at both the end of acute phase therapy and across 6 months of follow-up. In addition to effects on depressive symptoms and categorical outcomes (i.e., response and remission rates), dependent variables will include measures of dysfunctional attitudes, social functioning, quality of life, and health care costs and utilization. It is predicted that: 1) CCBT will be equivalent to CBT at week 16 and across the 6 month follow-up; and 2) CCBT will be significantly more cost-effective than CBT. Secondary aims include testing potential moderators of treatment outcome and the predicted absence of site differences (as an indicator of disseminability). This trial has significant implications for the public health because it will provide a rigorous test the clinical utility of CCBT against a model of conventional individual therapy that offers three times as much clinical contact. If equivalence and cost- effectiveness are demonstrated, the proposed research will set the stage for larger scale studies evaluating broader dissemination of CCBT.

描述（由申请人提供）：我们提出了一项两中心随机对照试验，评估计算机辅助认知行为疗法（CCBT）对重度抑郁症（MDD）门诊患者的疗效和成本效益。一项初步研究的结果表明，尽管 CCBT 减少了约 50% 的治疗师接触次数，但对于抑郁症结果而言，CCBT 至少与 8 周的传统个人 CBT 课程一样有效，而且对功能失调的态度和 CBT 知识的影响更大。我们现在建议对 CCBT 的治疗等效性和成本效益与完整的 16 周、20 个疗程的个人 CBT 进行更严格的测试，后者提供了三倍的治疗接触量。总共 172 名符合 SCID/DSM-IV MDD 标准的男性和女性门诊患者（每个中心 86 名）将在五年内进行随机分组。结果将由独立评估员在不了解所接受治疗的情况下进行评估。该研究的目的是在急性期治疗结束时和 6 个月的随访期间具有统计能力来测试 CCBT 和整个 CBT 疗程的等效性。除了对抑郁症状和分类结果（即反应率和缓解率）的影响外，因变量还包括功能失调的态度、社会功能、生活质量以及医疗保健成本和利用的衡量标准。预计： 1) CCBT 在第 16 周以及整个 6 个月的随访期间将等同于 CBT； 2) CCBT 将比 CBT 更具成本效益。次要目标包括测试治疗结果的潜在调节因素和预测不存在位点差异（作为传播性的指标）。这项试验对公众健康具有重大意义，因为它将对照提供三倍临床接触机会的传统个体治疗模型，对 CCBT 的临床效用进行严格测试。如果证明了等效性和成本效益，拟议的研究将为评估 CCBT 更广泛传播的更大规模研究奠定基础。

项目成果

Development and initial testing of a multimedia program for computer-assisted cognitive therapy.

• DOI: 10.1176/appi.psychotherapy.2002.56.1.76
• 发表时间: 2002
• 期刊: American journal of psychotherapy
• 影响因子: 2.5
• 作者: J. Wright;Andrew S. Wright;P. Salmon;A. Beck;J. Kuykendall;L. Goldsmith;Mary Beth Zickel

Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT.

• DOI: 10.1176/appi.ajp.2017.17010089
• 发表时间: 2018-03-01
• 期刊: The American journal of psychiatry
• 作者: Thase ME;Wright JH;Eells TD;Barrett MS;Wisniewski SR;Balasubramani GK;McCrone P;Brown GK
• 通讯作者: Brown GK

Computer-assisted psychotherapy

计算机辅助心理治疗

• DOI: 10.1007/bf00946167
• 发表时间: 1986
• 期刊: Journal of Contemporary Psychotherapy
• 影响因子: 2
• 作者: B. Block

Computers and psychotherapy: are we out of a job?

计算机和心理治疗：我们失业了吗？

• DOI: 10.1037/a0032408
• 发表时间: 2014
• 期刊: Psychotherapy (Chicago, Ill.)
• 作者: Barrett,MarnaS;Gershkovich,Marina
• 通讯作者: Gershkovich,Marina

Computer-assisted cognitive-behavioral therapy.

计算机辅助认知行为疗法。

• DOI: 10.1007/s11920-010-0152-4
• 发表时间: 2010
• 期刊: Current psychiatry reports
• 影响因子: 6.7
• 作者: Spurgeon,JoyceA;Wright,JesseH
• 通讯作者: Wright,JesseH