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简短跨诊断互联网治疗焦虑和抑郁的开放性试验

An open trial of a brief transdiagnostic internet treatment for anxiety and depression.

机构信息

The Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.

出版信息

Behav Res Ther. 2011 Dec;49(12):830-7. doi: 10.1016/j.brat.2011.09.007. Epub 2011 Sep 28.

Abstract

The present study evaluated the efficacy of a brief version of an internet-administered transdiagnostic CBT protocol, the Wellbeing Program (Titov et al., 2011), designed to treat three anxiety disorders and major depression within the same program. This brief version included the same core CBT skills as the original, but condensed the materials from 8 to 5 online lessons, reduced the duration of treatment from 10 to 8 weeks and did not include an online forum. Thirty-two individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder or social phobia received CBT-based online educational lessons, homework assignments, weekly contact from a clinical psychologist and automated emails. Eighty-one percent of participants completed the lessons within the 8 week program. Post-treatment and 3-month follow-up data were collected from 28/32 and 31/32 participants respectively. Participants improved significantly on the Depression Anxiety and Stress Scales - 21 Item, Patient Health Questionnaire - 9 Item, and Generalised Anxiety Disorder - 7 Item scales, with corresponding within-group effect sizes (Cohen's d) at follow-up of 1.05, .73, and .95, respectively. Participants rated the procedure as highly acceptable with gains of a similar magnitude as those found for the original program, but less time was spent per participant by the clinician in the present trial (mean=44.61 min, SD=34.45) compared to the original program (mean=84.76 min, SD=50.37). These results provide additional support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders and indicate that a brief version may be of benefit.

摘要

本研究评估了一种简短的互联网辅助跨诊断认知行为疗法(CBT)方案,即“幸福计划”(Titov 等人,2011 年)的疗效。该方案旨在在同一方案中治疗三种焦虑症和重度抑郁症。简短版包括与原始版本相同的核心 CBT 技能,但将在线课程的材料从 8 节压缩到 5 节,将治疗时间从 10 周缩短到 8 周,并且没有在线论坛。32 名主要诊断为重度抑郁症、广泛性焦虑症、惊恐障碍或社交恐惧症的患者接受了基于 CBT 的在线教育课程、家庭作业、每周与临床心理学家联系以及自动电子邮件。81%的参与者在 8 周的方案内完成了课程。对 28/32 名和 31/32 名参与者分别在治疗后和 3 个月随访时收集数据。参与者在抑郁焦虑和压力量表-21 项、患者健康问卷-9 项和广泛性焦虑症-7 项量表上的评分显著改善,组内效应量(Cohen's d)分别为 1.05、0.73 和 0.95。参与者对该程序的评价非常高,其增益与原始程序相当,但本试验中临床医生的时间投入比原始程序少(平均=44.61 分钟,SD=34.45)。这些结果为跨诊断 iCBT 在治疗焦虑和抑郁障碍方面的疗效提供了额外的支持,并表明简短版可能有益。

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