Kramer Jeannet, Conijn Barbara, Oijevaar Pien, Riper Heleen
Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, Netherlands.
J Med Internet Res. 2014 May 29;16(5):e141. doi: 10.2196/jmir.3261.
Up to 9% of young people suffer from depression. Unfortunately, many in need of help remain untreated. The Internet offers anonymous ways to help depressed youth, especially those who are reluctant to search for help because of fear of stigma.
Our goal was to evaluate the effectiveness of an individual chat treatment based on Solution-Focused Brief Therapy (SFBT) to young individuals aged 12-22 years with depressive symptoms by comparing it to a waiting list control group.
For this study, 263 young people with depressive symptoms were randomized to the Web-based SFBT intervention, PratenOnline, or to a waiting list control condition. The chat treatment was delivered by trained professionals. Groups were compared on depressive complaints as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) after 9 weeks and 4.5 months. For the chat group only, changes in depressive symptoms at 7.5 months after baseline were explored.
The experimental SFBT condition (n=131) showed significantly greater improvement than the waiting list condition (n=132) in depressive symptoms at 9 weeks and 4.5 months on the CES-D, with a small between group effect size at 9 weeks (d=0.18, 95% CI -0.10 to 0.47) and a large effect size at 4.5 months (d=0.79, 95% CI 0.45-1.08). The percentage of participants showing a reliable and clinically significant change in depression was significantly larger for the SFBT intervention at 4.5 months only (28.2% vs 11.4% for the waiting list, P<.001, number needed to treat=6). At 7.5 months, the SFBT group showed further improvements. However, results have to be considered carefully because of high attrition rates.
The Web-based SFBT chat intervention of PratenOnline was more effective than a waiting list control group in reducing depressive symptoms, and effects were larger at follow-up then at post-treatment. More studies are needed to find out if outcomes will be replicated, especially for those younger than 18 year old.
Netherlands Trial Register: NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696 (Archived by WebCite at http://www.webcitation.org/6DspeYWrJ).
高达9%的年轻人患有抑郁症。不幸的是，许多需要帮助的人仍未得到治疗。互联网提供了匿名方式来帮助抑郁的年轻人，尤其是那些因害怕污名化而不愿寻求帮助的人。
我们的目标是通过将基于聚焦解决短期治疗（SFBT）的个体聊天治疗与等待名单对照组进行比较，评估其对12至22岁有抑郁症状的年轻人的有效性。
在本研究中，263名有抑郁症状的年轻人被随机分配到基于网络的SFBT干预（PratenOnline）或等待名单对照条件。聊天治疗由训练有素的专业人员提供。在9周和4.5个月后，根据流行病学研究中心抑郁量表（CES-D）测量的抑郁主诉对两组进行比较。仅对聊天组，探索基线后7.5个月时抑郁症状的变化。
在9周和4.5个月时，实验性SFBT组（n = 131）在CES-D上的抑郁症状改善明显大于等待名单组（n = 132），9周时组间效应量较小（d = 0.18，95%CI -0.10至0.47），4.5个月时效应量较大（d = 0.79，95%CI 0.45 - 1.08）。仅在4.5个月时，显示出可靠且具有临床意义的抑郁变化的参与者百分比在SFBT干预组中显著更高（等待名单组为11.4%，SFBT干预组为28.2%，P <.001，需治疗人数 = 6）。在7.5个月时，SFBT组显示出进一步改善。然而，由于高损耗率，结果必须谨慎考虑。
PratenOnline基于网络的SFBT聊天干预在减轻抑郁症状方面比等待名单对照组更有效，随访时的效果大于治疗后。需要更多研究来确定结果是否会被复制，特别是对于18岁以下的人群。
荷兰试验注册库：NTR 1696；http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696（由WebCite存档于http://www.webcitation.org/6DspeYWrJ）
