Marks Isaac M, Mataix-Cols David, Kenwright Mark, Cameron Rachel, Hirsch Steven, Gega Lina
Department of Psychological Medicine, Charing Cross Campus, Imperial College School of Medicine, London, UK.
Br J Psychiatry. 2003 Jul;183:57-65. doi: 10.1192/bjp.183.1.57.
Most anxiety/depression is not effectively treated. Aims Open evaluation of a free clinic giving immediate computer-aided cognitive-behavioural therapy (CBT) self-help plus brief advice from a therapist.
Test of outcome of self-referrals who used one of four computer-aided CBT systems for depression, phobia/panic, general anxiety or obsessive-compulsive disorder.
The equivalent of one full-time clinician managed 355 referrals over a year. Of the 266 who had a screening interview 79% were suitable. Completers and non-completers of computer-aided CBT had similar pre-treatment features, with very chronic, moderately severe problems. Completers of the computer-aided self-help had a mean total of an hour's live therapist support over 12 weeks. They improved significantly and clinically meaningfully with three of the four systems and felt 'fairly satisfied'. Improvement resembled that in controlled and other trials of computer-aided CBT.
Computer-aided self-help is a 'clinician extender'that greatly cuts per-patient therapist time without impairing improvement. It could reduce the per-patient cost of CBT.
大多数焦虑/抑郁未得到有效治疗。目的：对一家免费诊所进行公开评估，该诊所提供即时计算机辅助认知行为疗法（CBT）自助服务以及来自治疗师的简短建议。
对使用四种计算机辅助CBT系统之一治疗抑郁症、恐惧症/恐慌症、广泛性焦虑症或强迫症的自我转诊患者的治疗结果进行测试。
相当于一名全职临床医生在一年中处理了355例转诊病例。在接受筛查访谈的266人中，79%适合。计算机辅助CBT的完成者和未完成者在治疗前具有相似的特征，存在非常慢性、中度严重的问题。计算机辅助自助服务的完成者在12周内平均总共获得了一小时的现场治疗师支持。他们使用四种系统中的三种有显著且具有临床意义的改善，并感到“相当满意”。改善情况与计算机辅助CBT的对照试验和其他试验相似。
计算机辅助自助服务是一种“临床医生扩展工具”，可大幅减少每位患者的治疗师时间，且不影响改善效果。它可以降低CBT的每位患者成本。
