McClay Carrie-Anne, Morrison Jill, McConnachie Alex, Williams Christopher
Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Administration Building, 1055 Great Western Road Glasgow, Glasgow City G12 0XH, UK.
Trials. 2013 Nov 19;14:392. doi: 10.1186/1745-6215-14-392.
Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service - the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the 'Living Life to the Full' (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning.
METHODS/DESIGN: Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out.
This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy.
Current Controlled Trials ISRCTN86292664.
抑郁症是一种心理健康状况，每年影响着数百万人，且全球发病率呈上升趋势。英国国家卫生与临床优化研究所（NICE）的抑郁症治疗指南推荐采用认知行为疗法（CBT）。然而，等候名单可能导致面对面治疗出现延迟。此外，有一部分人拒绝通过医疗服务寻求帮助，即所谓的治疗缺口。通过志愿部门组织提供的基于社区的团体干预措施进行CBT自我转诊，可能有助于解决这一问题。这项随机对照试验（RCT）的目的是确定这种指导性CBT自助课程，即由抑郁症行动慈善机构（AOD）提供的“充分生活”（LLTTF）课程的疗效。主要结局是使用患者健康问卷-9（PHQ9）抑郁量表在6个月时评估的抑郁水平。次要测量指标包括焦虑水平和社交功能。
方法/设计：情绪低落症状的参与者将通过报纸广告以及AOD网站从社区招募。参与者将立即或延迟获得指导性CBT自助课程——八节课程的LLTTF课程。主要终点将在6个月时，届时延迟组将接受干预。将评估抑郁、焦虑和社交功能水平，并进行经济分析。
这项RCT将测试LLTTF干预是否有效和/或具有成本效益。如果发现基于社区的LLTTF课程具有成本效益，它们可能对那些已经在医疗服务中寻求治疗的人以及在该环境之外寻求帮助的人都有帮助，从而扩大心理治疗的可及性。
当前受控试验ISRCTN86292664。
