Jonassaint Charles R, Gibbs Patrice, Belnap Bea Herbeck, Karp Jordan F, Abebe Kaleab K, Rollman Bruce L
, PhD, MHS, Center for Behavioral Health and Smart Technology, University of Pittsburgh, Pittsburgh, PA, USA.
, MS, Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA, USA.
BJPsych Open. 2017 Jan 2;3(1):1-5. doi: 10.1192/bjpo.bp.116.003657. eCollection 2017 Jan.
Computerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans.
We studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18-75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety.
Patients with moderate levels of mood and/or anxiety symptoms (PHQ-9 or GAD-7≥10) were randomised to receive either care-manager-guided access to the proven-effective Beating the Blues CCBT programme or usual care from their primary care doctor.
Compared with White participants, African Americans were less likely to start the CCBT programme (=0.01), and those who did completed fewer sessions and were less likely to complete the full programme (=0.03). Despite lower engagement, however, African Americans who started the CCBT programme experienced a greater decrease in self-reported depressive symptoms (estimated 8-session change: -6.6 -5.5; =0.06) and similar decrease in anxiety symptoms (-5.3 -5.6; =0.80) compared with White participants.
CCBT may be an efficient and scalable first-step to improving minority mental health and reducing disparities in access to evidence-based healthcare.
None.
© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
计算机化认知行为疗法（CCBT）有助于改善白人的心理健康状况。然而，尚无研究探讨CCBT对非裔美国人是否可接受且有益。
我们研究了91名非裔美国人和499名年龄在18 - 75岁的白人初级保健患者在使用CCBT以及自我报告的抑郁和焦虑症状变化方面的差异，这些患者参与了一项将在线抑郁症和焦虑症治疗纳入其中的协作护理随机临床试验。
情绪和/或焦虑症状处于中度水平（PHQ - 9或GAD - 7≥10）的患者被随机分配，要么接受护理经理指导下使用经证实有效的“战胜忧郁”CCBT项目，要么接受初级保健医生的常规护理。
与白人参与者相比，非裔美国人开始CCBT项目的可能性较小（=0.01），而开始该项目的人完成的疗程较少，完成整个项目的可能性也较小（=0.03）。然而，尽管参与度较低，但开始CCBT项目的非裔美国人自我报告的抑郁症状下降幅度更大（估计8个疗程后的变化：-6.6对-5.5；=0.06），焦虑症状下降幅度与白人参与者相似（-5.3对-5.6；=0.80）。
CCBT可能是改善少数族裔心理健康和减少循证医疗服务获取差距的一种有效且可扩展的第一步措施。
无。
©皇家精神科医学院2017年。本文是一篇开放获取文章，根据知识共享非商业性、无衍生作品（CC BY - NC - ND）许可协议分发。
