Transdiagnostic Mobile Health: Smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders
Transdiagnostic Mobile Health: Smartphone Intervention Reduces Depressive Symptoms in People With Mood and Psychotic Disorders
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DOI：
10.2196/13202
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发表时间：
2019-04-12
影响因子：
5.2
通讯作者：
Hallgren, Kevin A.
中科院分区：
文献类型：
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作者：
Ben-Zeev, Dror;Buck, Benjamin;Hallgren, Kevin A.
背景：抑郁症是最普遍的心理健康问题。对抑郁症有效治疗的需求远远超过了训练有素的心理健康专业人员的可获得性。智能手机和其他广泛可用的技术正越来越多地被用来提供抑郁症治疗。是否存在影响智能手机干预抑郁症有效性的患者特征尚不清楚。目的：本研究旨在评估患者特征(包括临床诊断、抑郁严重程度、精神病状况和当前抗抑郁药物的使用)是否影响基于证据的智能手机干预对抑郁症状的效果。方法：收集数据作为双臂随机对照试验的一部分，比较称为FOCUS的多模式智能手机干预和基于临床的干预。在这里，我们报告了82名参与者被分配到12周的集中治疗。我们在基线、干预后(3个月)和随访(6个月)时使用Beck抑郁问卷第二版(BDI-II)对抑郁症状进行了评估。我们使用2(组)x 2(时间)混合效应模型测试了BDI-II评分从基线到治疗后和6个月随访期间的差异：诊断(即，精神分裂症谱系障碍与双相情感障碍与重度抑郁)，抑郁严重程度(即，轻度-轻度抑郁)，精神病状态(即，是否有精神病症状)，以及抗抑郁药物的使用(即，结果：大多数受试者为男性(60%，49/82)、非裔美国人(65%，53/82)和中年(平均年龄49岁)，高中及以下文化程度(62%，51/82)。在用于对分析进行分层的变量中，住院患者的人口统计学没有差异。基线抑郁严重程度存在显著的组间交互作用(F-1，F-76.8=5.26，P=0.02[治疗后]和F-1，F-77.4=6.56，P=0.01[6个月随访])。中度或重度抑郁症患者治疗后显著改善(t(42)=3.20，P=0.003和t(42)=4.20，P
Background: Depression is the most prevalent mental health problem. The need for effective treatments for depression far outstrips the availability of trained mental health professionals. Smartphones and other widely available technologies are increasingly being leveraged to deliver treatments for depression. Whether there are patient characteristics that affect the potency of smartphone interventions for depression is not well understood.Objective: This study aimed to evaluate whether patient characteristics including clinical diagnosis, depression severity, psychosis status, and current use of antidepressant medications impact the effects of an evidence-based smartphone intervention on depressive symptoms.Methods: Data were collected as part of a 2-arm randomized controlled trial comparing a multimodal smartphone intervention called FOCUS with a clinic-based intervention. Here, we report on 82 participants assigned to 12 weeks of FOCUS treatment. We conducted assessments of depressive symptoms using the Beck Depression Inventory-second edition (BDI-II) at baseline, postintervention (3 months), and follow-up (6 months) We tested for differences in the amount of improvement in BDI-II scores from baseline to posttreatment and 6-month follow-up between each of the following patient subgroups using 2 (group) x 2 (time) mixed effects models: diagnosis (ie, schizophrenia spectrum disorder vs bipolar disorder vs major depressive disorder), depression severity (ie, minimal-mild vs moderate-severe depression), psychosis status (ie, presence vs absence of psychotic symptoms), and antidepressant use (ie, taking antidepressants vs not taking antidepressants).Results: The majority of participants were male (60%, 49/82), African American (65%, 53/82), and middle-aged (mean age 49 years), with a high school education or lower (62%, 51/82). There were no differences inpatient demographics across the variables that were used to stratify the analyses. There was a significant group x time interaction for baseline depression severity (F-1,F-76.8 =5.26, P=.02 [posttreatment] and F-1,F-77.4=6.56, P=.01 [6-month follow-up]). Participants with moderate or severe depression had significant improvements (t(42) =3.20, P=.003 [posttreatment] and t(42) =4.20, P