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基于互联网的自助干预对减少成年人同时出现的酒精滥用和抑郁症状的疗效:一项三臂随机对照试验的研究方案

Efficacy of an internet-based self-help intervention to reduce co-occurring alcohol misuse and depression symptoms in adults: study protocol of a three-arm randomised controlled trial.

作者信息

Schaub Michael P, Blankers Matthijs, Lehr Dirk, Boss Leif, Riper Heleen, Dekker Jack, Goudriaan Anna E, Maier Larissa J, Haug Severin, Amann Manuel, Dey Michelle, Wenger Andreas, Ebert David D

机构信息

Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland.

Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

BMJ Open. 2016 May 25;6(5):e011457. doi: 10.1136/bmjopen-2016-011457.

Abstract

INTRODUCTION

In the general population, alcohol use disorder and depression more often occur together than any other combination of a mental illness with a substance use disorder. It is important to have a cost-effective intervention that is able to reach at-risk individuals in the early stages of developing alcohol use disorders and depression disorders.

METHODS AND ANALYSIS

This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions' cost-utility and cost-effectiveness, a full economic evaluation will be performed.

ETHICS AND DISSEMINATION

This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peer-reviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites.

TRIAL REGISTRATION NUMBER

ISRCTN10323951.

摘要

引言

在普通人群中,酒精使用障碍和抑郁症同时出现的情况比任何其他精神疾病与物质使用障碍的组合更为常见。拥有一种具有成本效益的干预措施非常重要,这种措施能够在酒精使用障碍和抑郁症发展的早期阶段接触到高危个体。

方法与分析

本文介绍了一项三臂多中心随机对照试验(RCT)的方案,以测试基于互联网的自助干预措施“关爱自己”(TCOY)在减少酒精滥用和抑郁症状方面的疗效和成本效益,该试验将与等待名单对照组以及仅专注于问题饮酒的类似干预措施进行比较。积极干预措施包括基于动机性访谈原则和认知行为疗法方法设计的旨在减少酒精使用的模块,以及联合研究组中用于减轻抑郁症状的额外模块。将在基线时以及随机分组后的3个月和6个月收集数据。主要结局是过去7天内的酒精使用量。将研究一些次要结局指标。这些指标包括流行病学研究中心抑郁量表(CES-D)以及一项综合指标,该指标采用严重酒精使用障碍和CES-D的临界值以下的标准。数据分析将遵循意向性分析原则,使用(广义)线性混合模型。为了研究干预措施的成本效益和成本效果,将进行全面的经济评估。

伦理与传播

该随机对照试验将按照《赫尔辛基宣言》执行,并已获得2个当地伦理委员会的批准。研究结果将在会议上报告并发表在同行评审的出版物上。试验结果的参与者友好型摘要将发布在TCOY网站上。

试验注册号

ISRCTN10323951。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/159e/4885516/f906f9b4258e/bmjopen2016011457f01.jpg

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