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手机和网络程序对轻中度抑郁、焦虑和压力人群症状和功能结局的影响:一项随机对照试验。

Impact of a mobile phone and web program on symptom and functional outcomes for people with mild-to-moderate depression, anxiety and stress: a randomised controlled trial.

机构信息

Black Dog Institute, University of New South Wales, Hospital Road, Randwick, Sydney, New South Wales 2031, Australia.

出版信息

BMC Psychiatry. 2013 Nov 18;13:312. doi: 10.1186/1471-244X-13-312.

Abstract

BACKGROUND

Mobile phone-based psychological interventions enable real time self-monitoring and self-management, and large-scale dissemination. However, few studies have focussed on mild-to-moderate symptoms where public health need is greatest, and none have targeted work and social functioning. This study reports outcomes of a CONSORT-compliant randomised controlled trial (RCT) to evaluate the efficacy of myCompass, a self-guided psychological treatment delivered via mobile phone and computer, designed to reduce mild-to-moderate depression, anxiety and stress, and improve work and social functioning.

METHOD

Community-based volunteers with mild-to-moderate depression, anxiety and/or stress (N = 720) were randomly assigned to the myCompass program, an attention control intervention, or to a waitlist condition for seven weeks. The interventions were fully automated, without any human input or guidance. Participants' symptoms and functioning were assessed at baseline, post-intervention and 3-month follow-up, using the Depression, Anxiety and Stress Scale and the Work and Social Adjustment Scale.

RESULTS

Retention rates at post-intervention and follow-up for the study sample were 72.1% (n = 449) and 48.6% (n = 350) respectively. The myCompass group showed significantly greater improvement in symptoms of depression, anxiety and stress and in work and social functioning relative to both control conditions at the end of the 7-week intervention phase (between-group effect sizes ranged from d = .22 to d = .55 based on the observed means). Symptom scores remained at near normal levels at 3-month follow-up. Participants in the attention control condition showed gradual symptom improvement during the post-intervention phase and their scores did not differ from the myCompass group at 3-month follow-up.

CONCLUSIONS

The myCompass program is an effective public health program, facilitating rapid improvements in symptoms and in work and social functioning for individuals with mild-to-moderate mental health problems.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN 12610000625077.

摘要

背景

基于手机的心理干预能够实现实时自我监测和自我管理,并实现大规模传播。然而,很少有研究关注最需要公共卫生关注的轻度至中度症状,也没有针对工作和社交功能的研究。本研究报告了一项符合 CONSORT 标准的随机对照试验(RCT)的结果,该试验评估了 myCompass 的疗效,myCompass 是一种通过手机和计算机提供的自我指导的心理治疗方法,旨在减轻轻度至中度抑郁、焦虑和压力,并改善工作和社交功能。

方法

社区志愿者中患有轻度至中度抑郁、焦虑和/或压力(N=720)的志愿者被随机分配到 myCompass 方案、注意力对照干预或等待 7 周的条件。干预措施完全自动化,没有任何人工输入或指导。使用抑郁、焦虑和压力量表和工作和社会适应量表在基线、干预后和 3 个月随访时评估参与者的症状和功能。

结果

研究样本的干预后和随访时的保留率分别为 72.1%(n=449)和 48.6%(n=350)。与两个对照组相比,myCompass 组在 7 周干预阶段结束时,在抑郁、焦虑和压力症状以及工作和社会功能方面的改善显著更大(基于观察均值的组间效应大小范围从 d=0.22 到 d=0.55)。在 3 个月随访时,症状评分仍接近正常水平。注意力对照条件下的参与者在干预后阶段逐渐改善症状,其评分在 3 个月随访时与 myCompass 组无差异。

结论

myCompass 方案是一种有效的公共卫生方案,可促进轻度至中度心理健康问题个体的症状和工作及社会功能快速改善。

试验注册

澳大利亚新西兰临床试验注册 ACTRN 12610000625077。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9986/4225666/7ed8bd08cc65/1471-244X-13-312-1.jpg

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