Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
Psychiatry Res. 2011 May 15;187(1-2):113-20. doi: 10.1016/j.psychres.2010.11.015. Epub 2010 Dec 9.
The objective of this study is to evaluate the effectiveness of (guided) self-help in primary care for patients diagnosed with a minor or major mood and/or anxiety disorder. The study population consists of 120 (screened) primary care patients aged 18-65 years with at least one mood and/or anxiety disorder. The primary focus is the reduction of depressive and anxiety symptoms. The self-help courses (Problem Solving Treatment and exposure) took 6 weeks to complete. The self-help group reported slightly better outcomes than the care-as-usual group but these results were not significant: d=-0.18 (95% CI=-2.29 to 7.31) for symptoms of depression and d=-0.20 (95% CI=-0.74 to 2.29) for symptoms of anxiety. For patients with an anxiety disorder only, the anxiety symptoms decreased significantly compared to the care-as-usual group (d=-0.68; 95% CI=0.25 to 4.77). Self-help seems only slightly superior to care-as-usual and therefore might not be an effective tool in general practice. But the lack of results could also be due to our selection of patients or to our selection of GPs (with interest in psychiatric disorders). Nonetheless the promising signals with respect to anxiety disorders warrant further research.
本研究旨在评估初级保健中（指导）自助对被诊断为轻度或重度情绪和/或焦虑障碍患者的有效性。研究人群由 120 名（筛选出的）年龄在 18-65 岁、至少有一种情绪和/或焦虑障碍的初级保健患者组成。主要重点是减轻抑郁和焦虑症状。自助课程（问题解决治疗和暴露）需要 6 周完成。自助组的报告结果略好于常规护理组，但这些结果并不显著：抑郁症状的 d 值为-0.18（95%CI=-2.29 至 7.31），焦虑症状的 d 值为-0.20（95%CI=-0.74 至 2.29）。对于仅患有焦虑障碍的患者，与常规护理组相比，焦虑症状显著下降（d=-0.68；95%CI=0.25 至 4.77）。自助似乎仅略优于常规护理，因此在一般实践中可能不是一种有效的工具。但是，缺乏结果也可能是由于我们选择的患者或我们选择的全科医生（对精神障碍感兴趣）。尽管如此，焦虑障碍方面有希望的信号需要进一步研究。
