Johnston Luke, Dear Blake F, Gandy Milena, Fogliati Vincent J, Kayrouz Rony, Sheehan Joanne, Rapee Ronald M, Titov Nickolai
Centre for Emotional Health, Macquarie University, North Ryde, Australia
Centre for Emotional Health, Macquarie University, North Ryde, Australia.
Aust N Z J Psychiatry. 2014 Sep;48(9):819-27. doi: 10.1177/0004867414527524. Epub 2014 Mar 12.
The highest prevalence of mental health problems is amongst people aged 18-24, with anxiety disorders and depression the most common disorders in this age group. Few young adults seek and receive effective care, prompting calls for the development of 'youth friendly' services. The Internet is a modality that has the potential to facilitate engagement with, and delivery of psychological treatments to, young adults. To date, however, no therapist-guided Internet-delivered treatments have been developed specifically for young adults experiencing depression and anxiety.
To examine the efficacy and acceptability of a new therapist-guided Internet-delivered treatment for young adults aged 18-24 with symptoms of depression and anxiety.
Participants accessed the Mood Mechanic Course, which consisted of four lessons delivered over 5 weeks. Measures of depression, anxiety, distress and disability were gathered before and after treatment, and at 3-month follow-up. Results were provided by 78% and 83% of participants at post-treatment and 3-month follow-up, respectively. Data were analysed using mixed linear model analyses. The trial was registered as: ACTRN12612001099819.
Treatment significantly reduced depression and anxiety symptom severity, disability and distress at post-treatment and 3-month follow-up. Large within-group effect sizes were found at post-treatment and 3-month follow-up on all measures using both completer and estimated marginal means (Cohen's d = 1.02 to 1.41 and 0.94 to 1.45, respectively). The therapist spent an average of 37 minutes (SD = 18 minutes) in contact with participants during treatment. Participants rated the treatment as acceptable.
Treatment gains recorded at post-treatment were sustained at 3-month follow-up, and were consistent with those reported in meta-analyses of Internet-delivered treatments developed for the broader adult population with depression and anxiety. These results provide encouraging preliminary evidence for the efficacy of therapist-guided Internet-delivered treatments for anxiety and depression tailored for young adults.
心理健康问题在18 - 24岁人群中最为普遍，焦虑症和抑郁症是该年龄组最常见的疾病。很少有年轻人寻求并获得有效的治疗，这促使人们呼吁开发“对年轻人友好”的服务。互联网是一种有可能促进与年轻人接触并为其提供心理治疗的方式。然而，迄今为止，尚未专门为患有抑郁症和焦虑症的年轻人开发由治疗师指导的互联网治疗方法。
研究一种新的由治疗师指导的互联网治疗方法对18 - 24岁有抑郁和焦虑症状的年轻人的疗效和可接受性。
参与者参加了情绪调节课程，该课程由在5周内讲授的四节课组成。在治疗前后以及3个月随访时收集抑郁、焦虑、痛苦和残疾程度的测量数据。分别有78%和83%的参与者在治疗后和3个月随访时提供了结果。使用混合线性模型分析对数据进行分析。该试验注册为：ACTRN12612001099819。
治疗在治疗后和3个月随访时显著降低了抑郁和焦虑症状的严重程度、残疾程度和痛苦程度。使用完整数据和估计边际均值在治疗后和3个月随访时对所有测量指标都发现了较大的组内效应量（科恩d值分别为1.02至1.41和0.94至1.45）。治疗期间治疗师与参与者平均接触时间为37分钟（标准差 = 18分钟）。参与者对治疗的评价为可接受。
治疗后记录的治疗效果在3个月随访时得以维持，并且与针对患有抑郁症和焦虑症的更广泛成年人群开发的互联网治疗的荟萃分析中报告的效果一致。这些结果为针对年轻人量身定制的由治疗师指导的互联网焦虑和抑郁治疗的疗效提供了令人鼓舞的初步证据。
