Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
J Affect Disord. 2013 Dec;151(3):986-94. doi: 10.1016/j.jad.2013.08.022. Epub 2013 Aug 30.
Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.
Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n=33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.
Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery-Åsberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post-treatment showed a Cohen's d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within-group effects were d=0.99 and d=1.34, respectively.
The study was small with two active treatments and there was no placebo or credible control condition.
Guided ICBT is at least as effective as group-based CBT and long-term effects can be sustained up to 3 years after treatment.
已发现引导式互联网认知行为疗法（ICBT）对轻度至中度抑郁症的治疗有效，但与长期随访的更成熟的基于小组的认知行为疗法相比，尚无直接比较。
从普通人群中招募轻度至中度抑郁症患者，并将其随机分为引导式 ICBT（n=33）或现场小组治疗（n=36）组。在干预前后完成评估抑郁、焦虑和生活质量的测量。在治疗结束后一年和三年进行随访。
采用线性混合效应回归分析对意向治疗数据进行分析。基于蒙哥马利-Åsberg 抑郁量表自评版本的结果显示，两组在整个研究期间均有显著改善，表明引导式 ICBT 具有非劣效性，并且在三年随访时，引导式 ICBT 组甚至有优于基于小组的认知行为疗法的趋势。ICBT 条件在治疗后组内效应大小显示 Cohen's d=1.46，在 3 年随访时也具有类似的大效应，d=1.78。对于小组认知行为疗法，相应的组内效应分别为 d=0.99 和 d=1.34。
该研究规模较小，有两种积极的治疗方法，没有安慰剂或可信的对照组。
引导式 ICBT 至少与基于小组的认知行为疗法一样有效，并且在治疗后 3 年内可以维持长期效果。
