Silfvernagel Kristin, Carlbring Per, Kabo Julia, Edström Sara, Eriksson Jenny, Månson Lisa, Andersson Gerhard
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
J Med Internet Res. 2012 Jun 26;14(3):e65. doi: 10.2196/jmir.1853.
Previous studies on Internet-based treatment with minimal therapist guidance have shown promising results for several specific diagnoses.
To (1) investigate the effects of a tailored, therapist-guided, Internet-based treatment for individuals with reoccurring panic attacks, and (2) to examine whether people in different age groups (18-30 years and 31-45 years) would respond differently to the treatment.
We recruited 149 participants from an online list of individuals having expressed an interest in Internet treatment. Screening consisted of online questionnaires followed by a telephone interview. A total of 57 participants were included after a semistructured diagnostic interview, and they were randomly assigned to an 8-week treatment program (n = 29) or to a control condition (n = 28). Treatment consisted of individually prescribed cognitive behavior therapy text modules in conjunction with online therapist guidance. The control group consisted of people on a waitlist who later received treatment.
All dependent measures improved significantly immediately following treatment and at the 12-month follow-up. The between-group effect size on the primary outcome measure, the Panic Disorder Severity Scale, was d = 1.41 (95% confidence interval 0.81-1.95) at posttreatment. The within-group effect size from pretreatment to 12-month follow-up was d = 1.66 (95% confidence interval 1.14-2.35). Age group had no effect, suggesting that age did not influence the outcome.
Tailoring an Internet-based treatment can be a feasible approach in the treatment of panic symptoms and comorbid anxiety and depressive symptoms. Younger adults benefit as much as adults over 30 years and up to 45 years of age.
Clinicaltrials.gov NCT01296321; http://www.clinicaltrials.gov/ct2/show/NCT01296321 (Archived by WebCite at http://www.webcitation.org/65wddsqlL).
先前关于在最少治疗师指导下基于互联网的治疗的研究已显示出对几种特定诊断有可观的效果。
（1）调查一种为反复出现惊恐发作的个体量身定制的、有治疗师指导的基于互联网的治疗的效果，以及（2）检查不同年龄组（18 - 30岁和31 - 45岁）的人对该治疗的反应是否不同。
我们从一个对互联网治疗表示感兴趣的个人在线列表中招募了149名参与者。筛查包括在线问卷，随后进行电话访谈。经过半结构化诊断访谈后，共纳入57名参与者，他们被随机分配到一个为期8周的治疗项目组（n = 29）或对照组（n = 28）。治疗包括结合在线治疗师指导的个体化认知行为治疗文本模块。对照组由在等待名单上后来接受治疗的人组成。
所有相关测量指标在治疗后即刻及12个月随访时均有显著改善。在主要结局指标惊恐障碍严重程度量表上，治疗后组间效应量为d = 1.41（95%置信区间0.81 - 1.95）。从治疗前到12个月随访的组内效应量为d = 1.66（95%置信区间1.14 - 2.35）。年龄组没有影响，这表明年龄不影响治疗结果。
量身定制基于互联网的治疗可能是治疗惊恐症状以及共病的焦虑和抑郁症状的一种可行方法。年轻成年人与30岁及以上至45岁的成年人受益程度相同。
Clinicaltrials.gov NCT01296321；http://www.clinicaltrials.gov/ct2/show/NCT01296321（由WebCite存档于http://www.webcitation.org/65wddsqlL）
