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基于互联网的跨诊断维持治疗增强了住院认知行为治疗后的疗效稳定性:一项随机对照试验。

A transdiagnostic internet-based maintenance treatment enhances the stability of outcome after inpatient cognitive behavioral therapy: a randomized controlled trial.

机构信息

Philipps University Marburg, Marburg, Germany.

出版信息

Psychother Psychosom. 2013;82(4):246-56. doi: 10.1159/000345967. Epub 2013 Jun 1.

Abstract

BACKGROUND

High relapse rates following acute treatment for common mental health disorders support the importance of developing maintenance phase interventions. Internet-based interventions have been effective for a broad range of mental disorders, but less is known about their potential to enhance long-term outcomes of traditional face-to-face therapy. Therefore, the goal of the present study was to evaluate a transdiagnostic Internet-based maintenance treatment (TIMT) with the purpose of fostering long-term effects of inpatient psychotherapy.

METHOD

In this pragmatic randomized controlled trial, a sample of 400 inpatients with affective, neurotic, and/or behavioral disorders was assigned to either 12 weeks of TIMT + treatment as usual (TAU) or to TAU-only following hospital discharge. TIMT consists of a self-management module, asynchronous patient-coach communication, online patient support group, and online-based monitoring of psychopathological symptoms. Self-ratings of psychopathological symptoms were conducted at the beginning of inpatient treatment (t1), at discharge from inpatient treatment/start of TIMT (t2), and at 3-month (t3) and 12-month follow-ups (t4).

RESULTS

The TIMT + TAU group was superior to the TAU-only group with regard to differences in change of general psychopathological symptom severity from discharge to 3- and 12-month follow-up. Moreover, participants of the TIMT + TAU group showed less frequent symptom deteriorations and were more often in remission/recovery than controls.

CONCLUSION

TIMT effectively enhances long-term outcome of inpatient psychotherapy.

摘要

背景

急性治疗常见精神健康障碍后的高复发率支持开发维持阶段干预的重要性。基于互联网的干预措施已被证明对广泛的精神障碍有效,但对于它们增强传统面对面治疗长期效果的潜力知之甚少。因此,本研究的目的是评估一种跨诊断的基于互联网的维持治疗(TIMT),旨在促进住院心理治疗的长期效果。

方法

在这项实用的随机对照试验中,将 400 名患有情感、神经症和/或行为障碍的住院患者分为 TIMT + 常规治疗(TAU)组或仅 TAU 组,在出院后接受治疗。TIMT 包括自我管理模块、异步患者-教练沟通、在线患者支持小组和在线监测心理病理症状。心理病理症状的自我评估在住院治疗开始时(t1)、从住院治疗/开始 TIMT 时(t2)以及 3 个月(t3)和 12 个月随访(t4)进行。

结果

与仅 TAU 组相比,TIMT + TAU 组在出院后 3 个月和 12 个月随访时一般心理病理症状严重程度变化方面的差异更大。此外,TIMT + TAU 组的参与者出现症状恶化的频率较低,并且比对照组更容易缓解/康复。

结论

TIMT 有效地增强了住院心理治疗的长期效果。

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