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基于互联网的多发性硬化症抑郁自助治疗:一项随机对照试验的研究方案。

Internet-based self-help treatment for depression in multiple sclerosis: study protocol of a randomized controlled trial.

机构信息

Department of Psychiatry, VU University Medical Center Academic Anxiety Outpatient Clinic and GGZinGeest, A. J. Ernststraat 1187, Amsterdam, HL 1081, The Netherlands.

出版信息

BMC Psychiatry. 2012 Sep 11;12:137. doi: 10.1186/1471-244X-12-137.

Abstract

BACKGROUND

Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in general and could thus be a promising tool for treatment in MS.

METHODS/DESIGN: Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention (with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life, problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline (T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat principle.

DISCUSSION

If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive symptoms and to improve the quality of care.

TRIAL REGISTRATION

The Dutch Cochrane Center, NTR2772.

摘要

背景

多发性硬化症 (MS) 患者中抑郁较为常见,但往往治疗不足。一个重要的潜在因素可能是身体的限制,导致无法进行面对面的接触。基于互联网的治疗已被证明对抑郁症状有效,因此可能是 MS 治疗的一种有前途的工具。

方法/设计:在此,我们提出了一项研究方案,旨在探讨一项为期 5 周的基于互联网的自助问题解决治疗(PST)对 MS 患者中中重度抑郁症状的有效性,采用随机对照试验。我们计划纳入 166 名中重度抑郁症状的 MS 患者,他们将被随机分配到基于互联网的干预组(有或无支持性短信)或等待名单对照组。主要结局是贝克抑郁量表(BDI-II)总分的变化来定义抑郁症状的变化。次要结局将包括焦虑、疲劳、认知功能、MS 的身体和心理影响、生活质量、解决问题的技能、社会支持、掌握感、满意度和依从率的测量。评估将在基线(T0)、干预后一周内(T1)、四个月(T2)和十个月随访时(T3:仅干预组)进行。对照组将在相同的时间点进行测量。分析将基于意向治疗原则进行。

讨论

如果证明有效,基于互联网的 PST 将为治疗抑郁的 MS 患者提供新的可能性,并提高护理质量。

试验注册

荷兰 Cochrane 中心,NTR2772。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/3493307/150c09dba164/1471-244X-12-137-1.jpg

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