Usage and longitudinal effectiveness of a Web-based self-help cognitive behavioral therapy program for panic disorder.
Usage and longitudinal effectiveness of a Web-based self-help cognitive behavioral therapy program for panic disorder.
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用于恐慌症的基于网络的自助认知行为疗法计划的使用和纵向有效性。
DOI：
10.2196/jmir.7.1.e7
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发表时间：
2005-03-26
影响因子：
7.4
通讯作者：
Rudy, Laura
中科院分区：
文献类型：
--
作者：
Farvolden, Peter;Denisoff, Eilenna;Selby, Peter;Bagby, R Michael;Rudy, Laura
焦虑症是造成巨大痛苦和经济损失的常见问题。基于网络的自助方法对焦虑症的疗效已在许多对照试验中得到证实。然而，在对照试验的背景下，关于基于网络的免费干预措施的使用模式和有效性的数据很少。研究一种免费的、基于网络的12期认知行为疗法（CBT）治疗惊恐障碍和广场恐怖症的使用和纵向效果。对来自恐慌中心99695名用户的累积匿名数据进行了分析。研究人员检查了网站的使用统计数据，并对注册CBT项目的人进行了一项自我报告症状的纵向调查。主要结局指标是每次治疗（2-12次）开始时自我报告的恐慌发作频率和严重程度。在2002年9月1日至2004年2月1日期间，有99695名用户访问了恐慌中心484695次，1148097次页面浏览量。在同一时期，有1161名用户注册了CBT项目。在1161名注册用户中，只有12人（1.03%）完成了为期12周的项目，流失率极高。然而，即使对于那些在项目中停留不到12周的人，我们发现在自我报告的恐慌发作频率和严重程度上，将2周的数据与3周、6周或8周的数据进行比较，在统计学上有显著降低（P< 0.002）。例如，152名用户只完成了3次课程，他们每天的平均攻击次数从1.03次（第二周）减少到0.63次（第三周）（P< 0.001）。免费提供的基于web的自助服务可能与高流失率有关。然而，对于那些高度自我选择的人来说，他们在这个项目中取得了显著的进步。
Anxiety disorders are common problems that result in enormous suffering and economic costs. The efficacy of Web-based self-help approaches for anxiety disorders has been demonstrated in a number of controlled trials. However, there is little data regarding the patterns of use and effectiveness of freely available Web-based interventions outside the context of controlled trials. To examine the use and longitudinal effectiveness of a freely available, 12-session, Web-based, cognitive behavioral therapy (CBT) program for panic disorder and agoraphobia. Cumulative anonymous data were analyzed from 99695 users of the Panic Center. Usage statistics for the website were examined and a longitudinal survey of self-reported symptoms for people who registered for the CBT program was conducted. The primary outcome measures were self-reported panic-attack frequency and severity at the beginning of each session (sessions 2-12). Between September 1, 2002 and February 1, 2004, there were 484695 visits and 1148097 page views from 99695 users to the Panic Center. In that same time period, 1161 users registered for the CBT program. There was an extremely high attrition rate with only 12 (1.03%) out of 1161 of registered users completing the 12-week program. However, even for those who remained in the program less than 12 weeks we found statistically significant reductions (P<.002) in self-reported panic attack frequency and severity, comparing 2 weeks of data against data after 3, 6, or 8 weeks. For example, the 152 users completing only 3 sessions of the program reduced their average number of attacks per day from 1.03 (week 2) to 0.63 (week 3) (P<.001). Freely available Web-based self-help will likely be associated with high attrition. However, for the highly self-selected group who stayed in the program, significant improvements were observed.