Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden.
Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
Behav Res Ther. 2014 Aug;59:1-11. doi: 10.1016/j.brat.2014.05.007. Epub 2014 Jun 2.
A significant proportion of the general population suffers from anxiety disorders, often with comorbid psychiatric conditions. Internet-delivered cognitive behavior therapy (ICBT) has been found to be a potent treatment for patients with specific psychiatric conditions. The aim of this trial was to investigate the effectiveness and cost-effectiveness of ICBT when tailoring the treatment to address comorbidities and preferences for primary-care patients with a principal anxiety disorder. One hundred participants were recruited through their primary-care contact and randomized to either treatment or an active control group. The treatment consisted of 7-10 weekly individually assigned modules guided by online therapists. At post-treatment, 46% of the treatment group had achieved clinically significant improvement on the primary outcome measure (CORE-OM) and between-group effect sizes ranged from d = 0.20 to 0.86, with a mean effect of d = 0.59. At one-year follow-up, within-group effect sizes varied between d = 0.53 to 1.00. Cost analysis showed significant reduction of total costs for the ICBT group, the results were maintained at one-year follow-up and the incremental cost-effectiveness ratio favored ICBT compared to control group. Individually tailored ICBT is an effective and cost-effective treatment for primary-care patients with anxiety disorders with or without comorbidities.
Clinicaltrials.gov: NCT01390168.
相当一部分普通民众患有焦虑症,且常伴有合并的精神疾病。研究发现,互联网提供的认知行为疗法(ICBT)对特定精神疾病患者是一种有效的治疗方法。本试验旨在研究针对合并症和主要焦虑症的初级保健患者的偏好对 ICBT 进行个性化调整时的有效性和成本效益。通过初级保健联系人招募了 100 名参与者,并将他们随机分配到治疗组或积极对照组。治疗包括 7-10 个每周一次的单独分配的模块,由在线治疗师指导。在治疗后,治疗组中有 46%的患者在主要结局测量(CORE-OM)上达到了临床显著改善,组间效应大小范围从 d=0.20 到 0.86,平均效应为 d=0.59。在一年的随访中,组内效应大小在 d=0.53 到 1.00 之间变化。成本分析显示 ICBT 组的总成本显著降低,结果在一年的随访中得到维持,增量成本效益比有利于 ICBT 组而不是对照组。针对合并症或不合并症的初级保健焦虑症患者的个性化调整 ICBT 是一种有效且具有成本效益的治疗方法。
试验注册:Clinicaltrials.gov:NCT01390168。