Christensen Helen, Griffiths Kathleen M, Korten Ailsa
The Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
J Med Internet Res. 2002 Jan-Mar;4(1):e3. doi: 10.2196/jmir.4.1.e3.
Cognitive behavior therapy is well recognized as an effective treatment and prevention for depression when delivered face-to-face, via self-help books (bibliotherapy), and through computer administration. The public health impact of cognitive behavior therapy has been limited by cost and the lack of trained practitioners. We have developed a free Internet-based cognitive behavior therapy intervention (MoodGYM, http://moodgym.anu.edu.au) designed to treat and prevent depression in young people, available to all Internet users, and targeted to those who may have no formal contact with professional help services.
To document site usage, visitor characteristics, and changes in depression and anxiety symptoms among users of MoodGYM, a Web site delivering a cognitive-behavioral-based preventive intervention to the general public.
All visitors to the MoodGYM site over about 6 months were investigated, including 2909 registrants of whom 1503 had completed at least one online assessment. Outcomes for 71 university students enrolled in an Abnormal Psychology course who visited the site for educational training were included and examined separately. The main outcome measures were (1) site-usage measures including number of sessions, hits and average time on the server, and number of page views; (2) visitor characteristics including age, gender, and initial Goldberg self-report anxiety and depression scores; and (3) symptom change measures based on Goldberg anxiety and depression scores recorded on up to 5 separate occasions.
Over the first almost-6-month period of operation, the server recorded 817284 hits and 17646 separate sessions. Approximately 20% of sessions lasted more than 16 minutes. Registrants who completed at least one assessment reported initial symptoms of depression and anxiety that exceeded those found in population-based surveys and those characterizing a sample of University students. For the Web-based population, both anxiety and depression scores decreased significantly as individuals progressed through the modules. CONCLUSIONS Web sites are a practical and promising means of delivering cognitive behavioral interventions for preventing depression and anxiety to the general public. However, randomized controlled trials are required to establish the effectiveness of these interventions.
认知行为疗法在面对面实施、通过自助书籍（阅读疗法）以及计算机管理时，被公认为是治疗和预防抑郁症的有效方法。认知行为疗法对公共卫生的影响一直受到成本和缺乏训练有素的从业者的限制。我们开发了一种基于互联网的免费认知行为疗法干预措施（情绪健身房，http://moodgym.anu.edu.au），旨在治疗和预防年轻人的抑郁症，所有互联网用户均可使用，目标人群是那些可能与专业帮助服务没有正式接触的人。
记录“情绪健身房”网站（一个向公众提供基于认知行为的预防性干预措施的网站）的使用情况、访客特征以及用户抑郁和焦虑症状的变化。
对大约6个月内访问“情绪健身房”网站的所有访客进行了调查，包括2909名注册者，其中1503人完成了至少一次在线评估。纳入并单独检查了71名参加变态心理学课程并访问该网站进行教育培训的大学生的结果。主要结果指标包括：（1）网站使用指标，包括会话次数、点击量、在服务器上的平均时间以及页面浏览量；（2）访客特征，包括年龄、性别以及初始的戈德堡自评焦虑和抑郁评分；（3）基于在多达5个不同时间记录的戈德堡焦虑和抑郁评分的症状变化指标。
在运营的第一个近6个月期间，服务器记录了817284次点击和17646次独立会话。大约20%的会话持续时间超过16分钟。完成至少一次评估的注册者报告的抑郁和焦虑初始症状超过了基于人群的调查中发现的症状以及大学生样本的特征症状。对于基于网络的人群，随着个体逐步完成各个模块，焦虑和抑郁评分均显著下降。结论网站是向公众提供预防抑郁和焦虑的认知行为干预措施的一种实用且有前景的手段。然而，需要进行随机对照试验来确定这些干预措施的有效性。
