Center for Behavioral Intervention Technologies and the Feinberg School of Medicine, Northwestern University, Chicago, IL.
Center for Behavioral Intervention Technologies and the Feinberg School of Medicine, Northwestern University, Chicago, IL.
Am J Geriatr Psychiatry. 2017 Oct;25(10):1109-1119. doi: 10.1016/j.jagp.2017.04.015. Epub 2017 May 3.
This pilot study evaluated the feasibility and efficacy of two methods of delivering a cognitive behaviorally informed Internet intervention for depression for adults 65 years and older.
Forty-seven participants were enrolled and assigned to receive one of two versions of the Internet intervention, either delivered individually (III) or with peer support (II+PS), or to a wait list control group (WLC). Primary outcomes included change in depressive symptoms from baseline to post-intervention (week 8), site use, self-reported usability, and coach time. Secondary outcomes included measures of social support and isolation and anxiety.
Follow-up data were provided by 85.1% (40 of 47) of enrolled participants. There were significant differences in depression change across groups (F = 3.81, p = 0.03). Greater reductions in depressive symptoms were found for the III (p = 0.02) and II+PS (p = 0.03) compared with WLC, and significantly less coach time was required in the II+PS (p = 0.003).
These results highlight the potential of cognitive-behaviorally informed Internet interventions for older adults with depression, and indicate that peer-supported programs are both acceptable and equivalent to individually delivered Internet interventions. Including peer support may be a viable and potentially more cost-effective option for disseminating online treatments for depression for older adults.
本初步研究评估了两种为 65 岁及以上成年人提供认知行为信息的互联网抑郁症干预措施的可行性和效果。
招募了 47 名参与者,并将他们分配到接受两种互联网干预措施中的一种,即单独接受(III)或接受同伴支持(II+PS),或接受等待名单对照组(WLC)。主要结局包括从基线到干预后(第 8 周)的抑郁症状变化、网站使用情况、自我报告的可用性以及教练时间。次要结局包括社会支持和隔离以及焦虑的测量。
85.1%(40/47)的入组参与者提供了随访数据。各组之间的抑郁变化存在显著差异(F=3.81,p=0.03)。III 组(p=0.02)和 II+PS 组(p=0.03)的抑郁症状减轻程度明显大于 WLC 组,而 II+PS 组所需的教练时间明显减少(p=0.003)。
这些结果突出了认知行为信息互联网干预措施对老年抑郁症患者的潜在益处,并表明同伴支持计划既被接受,又与单独提供的互联网干预措施等效。纳入同伴支持可能是为老年抑郁症患者传播在线治疗的一种可行且潜在更具成本效益的选择。