Alvarez-Jimenez M, Alcazar-Corcoles M A, González-Blanch C, Bendall S, McGorry P D, Gleeson J F
Orygen Youth Health Research Centre, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia.
Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Spain.
Schizophr Res. 2014 Jun;156(1):96-106. doi: 10.1016/j.schres.2014.03.021. Epub 2014 Apr 17.
Internet and mobile-based interventions provide a unique opportunity to deliver cost-effective, accessible, time-unlimited support to people with psychosis. The aims of this study were to systematically compile and analyze the evidence on the acceptability, feasibility, safety and benefits of online and mobile-based interventions for psychosis.
Systematic review of peer-reviewed studies examining the usability, acceptability, feasibility, safety or efficacy of user-led, Internet or mobile-based interventions, with at least 80% of participants diagnosed with schizophrenia-spectrum disorders.
Of 38 potentially relevant articles, 12 were eligible for inclusion. Interventions included web-based psycho-education; web-based psycho-education plus moderated forums for patients and supporters; integrated web-based therapy, social networking and peer and expert moderation; web-based CBT; personalized advice based on clinical monitoring; and text messaging interventions. Results showed that 74-86% of patients used the web-based interventions efficiently, 75-92% perceived them as positive and useful, and 70-86% completed or were engaged with the interventions over the follow-up. Preliminary evidence indicated that online and mobile-based interventions show promise in improving positive psychotic symptoms, hospital admissions, socialization, social connectedness, depression and medication adherence.
Internet and mobile-based interventions for psychosis seem to be acceptable and feasible and have the potential to improve clinical and social outcomes. The heterogeneity, poor quality and early state of current research precludes any definite conclusions. Future research should investigate the efficacy of online and mobile interventions through controlled, well-powered studies, which investigate intervention and patient factors associated with take-up and intervention effects.
基于互联网和移动设备的干预措施为向精神病患者提供具有成本效益、可及性且不受时间限制的支持提供了独特机会。本研究的目的是系统地汇编和分析关于基于网络和移动设备的精神病干预措施的可接受性、可行性、安全性和益处的证据。
对同行评审研究进行系统综述，这些研究考察了由用户主导的、基于互联网或移动设备的干预措施的可用性、可接受性、可行性、安全性或有效性，其中至少80%的参与者被诊断为精神分裂症谱系障碍。
在38篇潜在相关文章中，12篇符合纳入标准。干预措施包括基于网络的心理教育；基于网络的心理教育加上为患者和支持者设立的有主持人的论坛；整合的基于网络的治疗、社交网络以及同伴和专家主持；基于网络的认知行为疗法；基于临床监测的个性化建议；以及短信干预。结果显示，74 - 86%的患者有效使用了基于网络的干预措施，75 - 92%的患者认为这些措施积极且有用，70 - 86%的患者在随访期间完成或参与了干预措施。初步证据表明，基于网络和移动设备的干预措施在改善阳性精神病症状、住院次数、社交、社会联系、抑郁和药物依从性方面显示出前景。
基于互联网和移动设备的精神病干预措施似乎是可接受且可行的，并且有可能改善临床和社会结局。当前研究的异质性、质量差以及尚处于早期阶段，使得无法得出任何明确结论。未来的研究应通过有对照、样本量充足的研究来调查基于网络和移动设备干预措施的疗效，这些研究要考察与接受度和干预效果相关的干预措施及患者因素。
