Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial
Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial
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DOI：
10.1017/s0033291714003006
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发表时间：
2015-07-01
影响因子：
6.9
通讯作者：
Kasai, K.
中科院分区：
文献类型：
--
作者：
Imamura, K.;Kawakami, N.;Kasai, K.
背景在这项研究中，我们调查了基于互联网的计算机认知行为治疗（iCBT）计划是否可以降低DSM-IV-TR重度抑郁发作（MDE）的风险。参与者来自一家公司和另一家公司的三个部门。那些在过去一个月内没有经历MDE的参与者被随机分配到干预组或对照组（每组n = 381）。干预组接受为期6周、6节课的iCBT课程。对照组在前6个月仅接受常规预防性心理健康服务，而对照组在6个月随访后有机会进行iCBT计划。主要结局是12个月随访期间新出现的DSM-IV-TR MDE，通过WHO复合国际诊断访谈（CIDI）网络版3.0版抑郁症部分进行评估。结果。在12个月随访时，干预组的MDE发生率显著低于对照组（Log-rank chi（2）= 7.04，p < 0.01）。当通过考克斯比例风险模型估计时，干预组的风险比为0.22（95%置信区间0.06-0.75）。目前的研究表明，iCBT计划是有效地防止MDE在工作人群中。然而，应该注意的是，MDE是通过自我报告来测量的，而CIDI可以更严格地按照DSM-IV标准来测量发作。
Background. In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers.Method. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section.Results. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank chi(2) = 7.04, p < 0.01). The hazard ratio for the intervention group was 0.22 (95% confidence interval 0.06-0.75), when estimated by the Cox proportional hazard model.Conclusions. The present study demonstrates that an iCBT program is effective in preventing MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.