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临床医生辅助的基于互联网的治疗对惊恐障碍有效:一项随机对照试验。

Clinician-assisted Internet-based treatment is effective for panic: A randomized controlled trial.

机构信息

St Vincent's Hospital, Darlinghurst, Sydney, NSW, Australia.

出版信息

Aust N Z J Psychiatry. 2010 Jul;44(7):599-607. doi: 10.3109/00048671003614171.

Abstract

OBJECTIVE

To determine the efficacy of an Internet-based clinician-assisted cognitive behavioural treatment program (the Panic program) for panic disorder (with or without agoraphobia).

METHOD

Fifty-nine individuals meeting diagnostic criteria for panic disorder with agoraphobia were randomly assigned to a treatment group or to a waitlist control group. Treatment group participants completed the Panic program, comprising six on-line lessons, weekly homework assignments, received weekly email contact from a psychiatry registrar, and contributed to a moderated online discussion forum with other participants. An intention-to-treat model was used for data analyses.

RESULTS

Twenty-three (79%) of treatment group participants completed all lessons within the 8-week program, and post-treatment data were collected from 22/29 treatment group and 22/25 waitlist group participants. Compared to the control group, treatment group participants reported significantly reduced symptoms of panic as measured by the Panic Disorder Severity Scale, Body Sensation Questionnaire, and Agoraphobic Cognitions Questionnaires. Significant reductions were also reported on measures of disability and depression. The mean within- and between-group effect size (Cohen's d) on the Panic Disorder Severity Scale was 0.93 and 0.59, respectively, and effects were sustained at 1-month follow-up. Mean therapist time per participant was 75 minutes for the program.

CONCLUSIONS

These results replicate those from the open trial of the Panic Program indicating the efficacy of the Internet-based clinician-assisted cognitive behavioural treatment program for panic disorder with agoraphobia.

摘要

目的

评估基于互联网的临床医生辅助认知行为治疗方案(惊恐方案)治疗惊恐障碍(伴或不伴广场恐怖症)的疗效。

方法

59 名符合惊恐障碍伴广场恐怖症诊断标准的个体被随机分配至治疗组或候补名单对照组。治疗组参与者完成了惊恐方案,包括 6 节在线课程、每周家庭作业、每周收到一名精神科住院医师的电子邮件联系,并与其他参与者一起参与了一个有主持人的在线讨论论坛。采用意向治疗模型进行数据分析。

结果

23 名(79%)治疗组参与者完成了 8 周方案中的所有课程,22/29 名治疗组和 22/25 名候补名单组参与者提交了治疗后数据。与对照组相比,治疗组参与者报告的惊恐症状明显减轻,惊恐障碍严重程度量表、躯体感觉问卷和广场恐怖症认知问卷的测量结果均如此。残疾和抑郁的测量结果也显著降低。惊恐障碍严重程度量表的组内和组间平均效应大小(Cohen's d)分别为 0.93 和 0.59,且在 1 个月随访时仍保持疗效。每名参与者的平均治疗师时间为 75 分钟。

结论

这些结果与惊恐方案的开放试验结果一致,表明基于互联网的临床医生辅助认知行为治疗方案治疗惊恐障碍伴广场恐怖症的疗效。

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