一项关于抑郁症网络治疗中自杀观念变化的临床审计。

A clinical audit of changes in suicide ideas with internet treatment for depression.

作者信息

Watts Sarah, Newby Jill M, Mewton Louise, Andrews Gavin

机构信息

Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Darlinghurst, New South Wales, Australia.

出版信息

BMJ Open. 2012 Sep 13;2(5). doi: 10.1136/bmjopen-2012-001558. Print 2012.

OBJECTIVES

To examine reductions in suicidal ideation among a sample of patients who were prescribed an internet cognitive behavior therapy (iCBT) course for depression.

DESIGN

Effectiveness study within a quality assurance framework.

SETTING

Primary care.

PARTICIPANTS

299 patients who were prescribed an iCBT course for depression by primary care clinicians.

INTERVENTION

Six lesson, fully automated cognitive behaviour therapy course delivered over the internet.

PRIMARY OUTCOME

suicidal ideation as measured by question 9 on the Patient Health Questionnaire (PHQ-9).

RESULTS

Suicidal ideation was common (54%) among primary care patients prescribed iCBT treatment for depression but dropped to 30% post-treatment despite minimal clinician contact and the absence of an intervention focused on suicidal ideation. This reduction in suicidal ideation was evident regardless of sex and age.

CONCLUSIONS

The findings do not support the exclusion of patients with significant suicidal ideation.

目的

研究为抑郁症患者开具互联网认知行为疗法（iCBT）课程后，其自杀意念的减少情况。

设计

质量保证框架内的有效性研究。

背景

初级保健。

参与者

299名由初级保健临床医生为其开具抑郁症iCBT课程的患者。

干预措施

通过互联网提供的六节全自动认知行为疗法课程。

主要结局

采用患者健康问卷（PHQ-9）第9题测量的自杀意念。

结果

在接受抑郁症iCBT治疗的初级保健患者中，自杀意念很常见（54%），但治疗后降至30%，尽管临床医生接触极少且未针对自杀意念进行干预。无论性别和年龄，自杀意念的这种减少都是明显的。

结论

研究结果不支持排除有明显自杀意念的患者。