School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Sydney, NSW, Australia.
Depress Anxiety. 2014 Nov;31(11):912-5. doi: 10.1002/da.22302.
Internet-delivered cognitive behavioral therapy (iCBT) was developed to overcome some of the barriers in accessing best practice face-to-face CBT. iCBT affords many benefits, such as high fidelity, greater accessibility, convenience, and reduced cost to patients and health-care systems. Recent meta-analyses of iCBT for depressive and anxiety disorders demonstrate large effect size for superiority of iCBT over control conditions (ES>.95; number needed to treat (NNT) = 2) and data collected in routine practice supports the effectiveness of these programs. Tailoring treatment to match patient variables may be one means to increase adherence and optimize clinical outcomes. However, we propose that a "personalized medicine" approach will require looking beyond patient characteristics and comorbidities to consideration of the cognitive processes that subserve depression and anxiety symptomatology.
互联网提供的认知行为疗法（iCBT）旨在克服一些获取最佳实践面对面认知行为疗法的障碍。iCBT 具有许多优点，例如高保真度、更大的可及性、便利性，以及对患者和医疗保健系统的成本降低。最近对 iCBT 治疗抑郁和焦虑障碍的荟萃分析表明，iCBT 优于对照条件的效果显著（ES>.95；需要治疗的人数（NNT）=2），并且在常规实践中收集的数据支持这些方案的有效性。根据患者变量调整治疗方案可能是提高依从性和优化临床结果的一种方法。然而，我们提出，“个性化医疗”方法需要超越患者特征和合并症，考虑支持抑郁和焦虑症状的认知过程。
