Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK.
Department of Psychiatry, Beth Israel Deaconess Medical Canter, Harvard Medical School, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
J Affect Disord. 2017 Aug 15;218:15-22. doi: 10.1016/j.jad.2017.04.046. Epub 2017 Apr 25.
Various psychological interventions are effective for reducing symptoms of anxiety when used alone, or as an adjunct to anti-anxiety medications. Recent studies have further indicated that smartphone-supported psychological interventions may also reduce anxiety, although the role of mobile devices in the treatment and management of anxiety disorders has yet to be established.
We conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) reporting the effects of psychological interventions delivered via smartphone on symptoms of anxiety (sub-clinical or diagnosed anxiety disorders). A systematic search of major electronic databases conducted in November 2016 identified 9 eligible RCTs, with 1837 participants. Random-effects meta-analyses were used to calculate the standardized mean difference (as Hedges' g) between smartphone interventions and control conditions.
Significantly greater reductions in total anxiety scores were observed from smartphone interventions than control conditions (g=0.325, 95% C.I.=0.17-0.48, p<0.01), with no evidence of publication bias. Effect sizes from smartphone interventions were significantly greater when compared to waitlist/inactive controls (g=0.45, 95% C.I.=0.30-0.61, p<0.01) than active control conditions (g=0.19, 95% C.I.=0.07-0.31, p=0.003).
The extent to which smartphone interventions can match (or exceed) the efficacy of recognised treatments for anxiety has yet to established.
This meta-analysis shows that psychological interventions delivered via smartphone devices can reduce anxiety. Future research should aim to develop pragmatic methods for implementing smartphone-based support for people with anxiety, while also comparing the efficacy of these interventions to standard face-to-face psychological care.
各种心理干预措施在单独使用或作为抗焦虑药物的辅助手段时，都能有效减轻焦虑症状。最近的研究进一步表明，智能手机支持的心理干预措施也可能减轻焦虑，尽管移动设备在治疗和管理焦虑症中的作用尚未确定。
我们对所有报告通过智能手机提供的心理干预对焦虑症状（亚临床或诊断为焦虑症）影响的随机对照试验（RCT）进行了系统评价和荟萃分析。2016 年 11 月，通过对主要电子数据库的系统搜索，确定了 9 项符合条件的 RCT，共有 1837 名参与者。采用随机效应荟萃分析计算智能手机干预与对照组之间的标准化均数差值（作为 Hedges'g）。
与对照组相比，智能手机干预组的总焦虑评分显著降低（g=0.325，95%置信区间：0.17-0.48，p<0.01），且不存在发表偏倚。与等待/非活动对照组（g=0.45，95%置信区间：0.30-0.61，p<0.01）相比，智能手机干预组的效果明显大于活动对照组（g=0.19，95%置信区间：0.07-0.31，p=0.003）。
智能手机干预措施在多大程度上可以与（或超过）公认的焦虑症治疗方法的疗效相匹配尚未确定。
本荟萃分析表明，通过智能手机设备提供的心理干预可以减轻焦虑。未来的研究应旨在开发用于为焦虑症患者提供基于智能手机支持的实用方法，同时比较这些干预措施与标准面对面心理护理的疗效。
