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治疗老年人的焦虑和抑郁:比较指导性与自我指导性互联网认知行为疗法的随机对照试验

Treating anxiety and depression in older adults: randomised controlled trial comparing guided . self-guided internet-delivered cognitive-behavioural therapy.

作者信息

Titov Nickolai, Fogliati Vincent J, Staples Lauren G, Gandy Milena, Johnston Luke, Wootton Bethany, Nielssen Olav, Dear Blake F

机构信息

, PhD.

, PhD, eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.

出版信息

BJPsych Open. 2016 Feb 1;2(1):50-58. doi: 10.1192/bjpo.bp.115.002139. eCollection 2016 Jan.

Abstract

BACKGROUND

Symptoms of anxiety and depression are prevalent in older adults.

AIMS

To compare clinician-guided and self-guided versions of a transdiagnostic internet-delivered cognitive-behavioural therapy (iCBT) intervention for adults aged 60 years and above.

METHOD

Adults (=433) with symptoms of anxiety and depression were randomly allocated to: (1) clinician-guided treatment (=153); (2) initial clinician interview followed by self-guided treatment (=140); or (3) self-guided treatment without interview (=140).

RESULTS

Large reductions ( ≥1.00) in symptoms of depression and anxiety were observed across groups, and sustained at follow-up. No differences were observed in clinical outcomes or satisfaction ratings. Age did not affect outcomes.

CONCLUSIONS

Carefully developed iCBT interventions may significantly reduce symptoms of anxiety and depression in older adults when delivered in either clinician-guided or self-guided formats.

DECLARATION OF INTEREST

N.T. and B.F.D. developed the Wellbeing Plus Course but derive no financial benefit from it.

COPYRIGHT AND USAGE

© 2016 The Royal College of Psychiatrists. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

摘要

背景

焦虑和抑郁症状在老年人中很普遍。

目的

比较针对60岁及以上成年人的跨诊断互联网认知行为疗法(iCBT)干预的临床医生指导版和自我指导版。

方法

将有焦虑和抑郁症状的成年人(=433人)随机分配到:(1)临床医生指导治疗组(=153人);(2)先进行临床医生初次访谈,然后进行自我指导治疗组(=140人);或(3)无访谈的自我指导治疗组(=140人)。

结果

各治疗组的抑郁和焦虑症状均大幅减轻(≥1.00),且在随访时持续存在。临床结局或满意度评分方面未观察到差异。年龄不影响治疗结果。

结论

精心开发的iCBT干预措施,无论是以临床医生指导还是自我指导的形式提供,都可能显著减轻老年人的焦虑和抑郁症状。

利益声明

N.T.和B.F.D.开发了“幸福+课程”,但未从中获得经济利益。

版权与使用

©2016英国皇家精神科医学院。本文是一篇开放获取文章,根据知识共享非商业性、禁止演绎(CC BY-NC-ND)许可协议分发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/4995559/46e7806387d9/bjporcpsych002139-g001.jpg

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