与互联网支持小组相比，针对抑郁和焦虑人群的在线表达性写作：一项随机试验。
Direction to an Internet Support Group Compared With Online Expressive Writing for People With Depression And Anxiety: A Randomized Trial.
机构信息
Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom.
出版信息
JMIR Ment Health. 2016 May 17;3(2):e12. doi: 10.2196/mental.5133.
BACKGROUND
Depression and anxiety are common, often comorbid, conditions, and Internet support groups for them are well used. However, little rigorous research has been conducted on the outcome of these groups.
OBJECTIVE
This study aimed to evaluate the efficacy of an Internet support group in reducing depression and anxiety, and increasing social support and life satisfaction.
METHODS
A randomized trial compared direction to an existing Internet support group for depression and anxiety with an online expressive writing condition. A total of 863 (628 female) United Kingdom, United States, and Canadian volunteers were recruited via the Internet. Online, self-report measures of depression, anxiety, social support, and satisfaction with life were administered at baseline, 3, and 6 months.
RESULTS
All four outcomes - depression, anxiety, social support, and satisfaction with life - improved over the 6 months of the study (all P <.001). There was no difference in outcome between the two conditions: participants responded similarly to the expressive writing and the Internet support group. Engagement with the Internet support group was low, it had high 6-month attrition (692/795, 87%) and low adherence, and it received mixed and often negative feedback. The main problems reported were a lack of comfort and connection with others, negative social comparisons, and the potential for receiving bad advice. Expressive writing had lower attrition (194/295, 65%) and participants reported that it was more acceptable.
CONCLUSIONS
Until further evidence accumulates, directing people with depression and anxiety to Internet support groups cannot be recommended. On the other hand, online expressive writing seems to have potential, and its use for people with depression and anxiety warrants further investigation.
TRIAL REGISTRATION
Clinicaltrials.gov NCT01149265; https://clinicaltrials.gov/ct2/show/NCT01149265 (Archived by WebCite at http://www.webcitation.org/6hYISlNFT).
背景
抑郁和焦虑是常见的、常并发的疾病，人们经常使用互联网支持小组来应对这些疾病。然而，针对这些小组的结果，很少有严格的研究。
目的
本研究旨在评估互联网支持小组在减轻抑郁和焦虑、增加社会支持和生活满意度方面的效果。
方法
一项随机试验比较了向现有的抑郁和焦虑互联网支持小组提供指导与在线表达性写作的效果。共有 863 名（628 名女性）来自英国、美国和加拿大的志愿者通过互联网招募。在基线、3 个月和 6 个月时，通过在线自我报告评估抑郁、焦虑、社会支持和生活满意度。
结果
所有四项结果——抑郁、焦虑、社会支持和生活满意度——在研究的 6 个月内均有所改善（均 P <.001）。两种情况下的结果没有差异：参与者对表达性写作和互联网支持小组的反应相似。互联网支持小组的参与度较低，6 个月的流失率较高（795 人中有 692 人，占 87%），且参与度低，收到的反馈好坏参半，且常常是负面的。报告的主要问题是与他人缺乏舒适感和联系、负面的社会比较以及可能收到不良建议。表达性写作的流失率较低（295 人中有 194 人，占 65%），参与者认为其更易接受。
结论
在进一步的证据积累之前，不能建议将有抑郁和焦虑问题的人引导到互联网支持小组。另一方面，在线表达性写作似乎有潜力，其对抑郁和焦虑人群的应用值得进一步研究。
试验注册
Clinicaltrials.gov NCT01149265；https://clinicaltrials.gov/ct2/show/NCT01149265（由 WebCite 存档，http://www.webcitation.org/6hYISlNFT）。
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