Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
Cogn Behav Ther. 2011;40(3):159-73. doi: 10.1080/16506073.2011.576699. Epub 2011 Jul 20.
Generalized anxiety disorder (GAD) has been effectively treated with cognitive behavioural therapy (CBT) in face-to face settings. Internet-delivered CBT could be a way to increase the accessibility and affordability of CBT for people suffering from GAD. The aim of this study was to evaluate the efficacy of guided Internet-delivered CBT for GAD in a controlled trial with a wait-list control group. A total of 89 participants were included following online screening and a structured psychiatric telephone interview. Participants were randomized to either an 8-week treatment group (n = 44) or a wait-list control group (n = 45). Treatment consisted of a self-help program based on CBT principles and applied relaxation along with therapist guidance. The main outcome measure was the Penn State Worry Questionnaire. Ratings of clinical improvement and symptoms were included as well as secondary outcome measures dealing with anxiety, depression, and quality of life. Among the treatment group participants, 13.6% did not complete the posttreatment measures. The treatment group showed significant improvement compared with the control group on all outcome measures. Large effect sizes (Cohen's d > 0.8) were found both within the treatment group and between the groups in favor of the treatment on all outcome measures except on a measure of quality of life. Results at 1- and 3-year follow-up indicated that treatment results improved or were maintained. The authors conclude that Internet-delivered CBT with therapist support can reduce symptoms and problems related to GAD.
广泛性焦虑障碍（GAD）已通过面对面的认知行为疗法（CBT）得到有效治疗。互联网提供的 CBT 可能是一种增加 GAD 患者获得 CBT 的可及性和负担能力的方法。本研究旨在通过与等待名单对照组的对照试验，评估针对 GAD 的有指导的互联网 CBT 的疗效。在在线筛选和结构化精神病电话访谈后，共有 89 名参与者被纳入研究。参与者被随机分配到 8 周治疗组（n = 44）或等待名单对照组（n = 45）。治疗包括基于 CBT 原则的自助计划和应用放松以及治疗师指导。主要结局指标是宾夕法尼亚州担忧问卷。包括临床改善和症状的评分以及涉及焦虑、抑郁和生活质量的次要结局指标。在治疗组参与者中，有 13.6%的人未完成治疗后测量。与对照组相比，治疗组在所有结局指标上均显示出显著改善。在治疗组和组间均发现了较大的效应量（Cohen's d > 0.8），除了一项生活质量测量外，所有结局指标均有利于治疗。1 年和 3 年随访结果表明，治疗效果得到改善或维持。作者得出结论，有治疗师支持的互联网 CBT 可以减轻 GAD 相关的症状和问题。
