School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland; Department of Psychology, City, University of London, United Kingdom.
Research Department, Gaia Group, Hamburg, Germany; Department of Psychology, City, University of London, United Kingdom.
Psychiatry Res. 2017 Oct;256:371-377. doi: 10.1016/j.psychres.2017.06.081. Epub 2017 Jun 27.
Computerised cognitive behavioural therapy (cCBT) programmes differ widely but have rarely been evaluated separately through meta-analysis. Through a meta-analysis of randomised controlled trials, we investigated the effectiveness of 'Deprexis', an unconventional and individually-tailored cCBT programme for depression. Comparisons from eight studies (N = 2402) demonstrated the effectiveness of Deprexis for depressive symptoms at post-intervention, with a medium effect size (g = 0.54, 95% CI: 0.39-0.69). Analogous results arose when study quality, screening, and randomisation procedure were taken into account. The level of guidance provided alongside Deprexis had a statistically non-significant impact upon the effect size. There was no significant difference in the performance of Deprexis in developer-led trials compared with non-developer trials, and no publication bias was detected. The weighted-average dropout rate for participants allocated to Deprexis treatment arms in included studies was 26.5%. Based primarily on trials in naturalistic community settings, the findings support the effectiveness of Deprexis for depressive symptoms. The positive findings add to the growing evidence-base for individually-tailored cCBT programmes and point to the need for further investigations of apparent systematic differences in the effectiveness of specific cCBT programmes.
计算机化认知行为疗法(cCBT)方案差异很大,但通过荟萃分析对其进行单独评估的情况很少。通过对随机对照试验的荟萃分析,我们调查了一种非传统的、个性化的 cCBT 方案“Deprexis”治疗抑郁症的有效性。对来自八项研究(N=2402)的比较表明,Deprexis 在干预后对抑郁症状有效,具有中等效应量(g=0.54,95%CI:0.39-0.69)。当考虑研究质量、筛选和随机化程序时,也得出了类似的结果。Deprexis 提供的指导水平对效应量没有统计学上的显著影响。开发者主导的试验与非开发者试验中 Deprexis 的表现没有显著差异,也没有发现发表偏倚。纳入研究中分配到 Deprexis 治疗组的参与者的加权平均辍学率为 26.5%。主要基于自然社区环境中的试验,这些发现支持了 Deprexis 对抑郁症状的有效性。阳性结果增加了对个性化 cCBT 方案的不断增长的证据基础,并表明需要进一步调查特定 cCBT 方案有效性的明显系统差异。