Imamura Kotaro, Kawakami Norito, Tsuno Kanami, Tsuchiya Masao, Shimada Kyoko, Namba Katsuyuki
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Affect Disord. 2016 Oct;203:30-37. doi: 10.1016/j.jad.2016.05.045. Epub 2016 May 31.
The present randomized controlled trial aimed to examine whether a newly developed psychoeducational information website on stress and depression was effective in improving depressive symptoms at one- and four-month follow-ups among workers in Japan.
Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to access a psychoeducational website named the "UTSMed" within 4 months after the baseline survey. Depressive symptoms (Beck Depression Inventory II; BDI-II) were assessed as a primary outcome, at baseline, and one- and four-month follow-ups for both intervention and control groups. The analyses were conducted separately by the three subgroups (high-risk, moderate-risk, and low-risk).
A total of 1236 workers completed the baseline survey. Participants were randomly allocated to an intervention or control group (N=618 for each), with the subgroups of high-risk (7-8%), moderate-risk (47%) and low-risk (45-46%) in each group. A significant intervention effect on improving depressive symptoms (t=-2.35, P =0.02, d=-0.57) was observed at 1-month follow-up only in the high-risk subgroup.
The present study did not use a stratified permuted-block randomization.
A web-based psychoeducation approach may not be effective enough in improving depressive symptoms in a general population of workers, while it may be effective for workers who had recently sought help for mental health.
本随机对照试验旨在研究一个新开发的关于压力和抑郁的心理教育信息网站,在日本工人的1个月和4个月随访中,对改善抑郁症状是否有效。
参与者从日本一个网络调查网站的注册会员中招募。符合纳入标准的参与者被随机分配到干预组或对照组。在基线调查后,立即邀请干预组在基线调查后的4个月内访问一个名为“UTSMed”的心理教育网站。抑郁症状(贝克抑郁量表第二版;BDI-II)作为主要结局指标,在基线、干预组和对照组的1个月及4个月随访时进行评估。分析按三个亚组(高风险、中度风险和低风险)分别进行。
共有1236名工人完成了基线调查。参与者被随机分配到干预组或对照组(每组N = 618),每组中高风险亚组占7 - 8%,中度风险亚组占47%,低风险亚组占45 - 46%。仅在高风险亚组的1个月随访时观察到对改善抑郁症状有显著的干预效果(t = -2.35,P = 0.02,d = -0.57)。
本研究未使用分层区组随机化。
基于网络的心理教育方法在改善普通工人人群的抑郁症状方面可能不够有效,而对于最近寻求心理健康帮助的工人可能有效。