Clinical Research Unit for Anxiety and Depression (CRUfAD), School of Psychiatry, The University of New South Wales (UNSW) at St Vincent's Hospital, Level 4, The O'Brien Centre St. Vincent's Hospital, 394-404 Victoria Street Darlinghurst, NSW, 2010, Sydney, Australia,
Curr Psychiatry Rep. 2015 Jan;17(1):533. doi: 10.1007/s11920-014-0533-1.
Anxiety disorders are common and disabling. Cognitive behavior therapy is the treatment of choice but is often difficult to obtain. Automated, internet-delivered, cognitive behavior therapy (iCBT) courses may be an answer. There are three recent systematic reviews of randomized controlled trials that show that the benefits are substantial (d = 1.0) and similar to face to face CBT. There are two large effectiveness trials that demonstrate strong effects when iCBT is used in primary care; 60 % of patients who complete the courses no longer meet diagnostic criteria. The courses are suitable for most people with a primary anxiety disorder. Research studies usually exclude people whose anxiety is secondary to schizophrenia, bipolar disorder, or substance abuse or who are actively suicidal. Little additional input from clinicians is required. Patients find the courses very convenient. Clinically, the principal advantage is the fidelity of the treatment. What you prescribe is what the patient sees.
焦虑障碍很常见且会致残。认知行为疗法是首选治疗方法，但往往难以获得。自动化的、基于互联网的认知行为疗法（iCBT）课程可能是一个答案。最近有三项针对随机对照试验的系统评价显示，其疗效显著（d=1.0），与面对面的 CBT 相似。有两项大型效果试验表明，在初级保健中使用 iCBT 时会产生强烈的效果；完成课程的 60%的患者不再符合诊断标准。这些课程适用于大多数患有原发性焦虑症的人。研究通常将那些焦虑继发于精神分裂症、双相情感障碍或物质滥用，或有自杀念头的人排除在外。临床医生需要的额外投入很少。患者觉得这些课程非常方便。从临床角度来看，主要的优势是治疗的保真度。你规定什么，患者就看到什么。
