Agyapong Vincent I O, Juhás Michal, Ohinmaa Arto, Omeje Joy, Mrklas Kelly, Suen Victoria Y M, Dursun Serdar M, Greenshaw Andrew J
Faculty of Health Sciences, Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada.
Institute of Health Economics and School of Public Health, University of Alberta, Edmonton, AB, Canada.
BMC Psychiatry. 2017 Aug 2;17(1):286. doi: 10.1186/s12888-017-1448-2.
Depression is projected to be the primary cause of disability worldwide by 2030. In a recent survey, the most commonly cited unmet need among 42.4% of depressed Albertans was the lack of sufficient, accessible, and affordable counselling. Our aim was to test the efficacy of a supportive text messaging mobile health intervention in improving treatment outcomes in depressed patients.
We performed a single-rater-blinded randomized trial involving 73 patients with Major Depressive Disorder. Patients in the intervention group (n = 35) received twice-daily supportive text messages for 3 months while those in the control group (n = 38) received a single text message every fortnight thanking them for participating in the study. The primary outcome of this study was: "Mean changes in the BDI scores from baseline".
After adjusting for baseline BDI scores, a significant difference remained in the 3 month mean BDI scores between the intervention and control groups: (20.8 (SD = 11.7) vs. 24.9 (SD = 11.5), F (1, 60) = 4.83, p = 0.03, ηp2 = 0.07). The mean difference in the BDI scores change was significant with an effect size (Cohen's d) of 0.67. Furthermore, after adjusting for baseline scores, a significant difference remained in the 3 month mean self-rated VAS scores (EQ-5D-5 L scale) between the intervention and control groups, 65.7 (SD = 15.3) vs. 57.4 (SD = 22.9), F (1, 60) =4.16, p = 0.05, ηp2 = 0.065. The mean difference in change mean self-rated VAS scores was also statistically significant with an effect size (Cohen's d) of 0.51.
Our findings suggest that supportive text messages are a potentially useful psychological intervention for depression, especially in underserved populations. Further studies are needed to explore the implications of our findings in larger clinical samples.
ClinicalTrials.gov NCT02327858 . Registered 24 December 2014.
预计到2030年，抑郁症将成为全球致残的主要原因。在最近一项调查中，42.4%的艾伯塔省抑郁症患者最常提到的未满足需求是缺乏足够、可及且负担得起的心理咨询服务。我们的目的是测试一种支持性短信移动健康干预措施在改善抑郁症患者治疗效果方面的疗效。
我们进行了一项单评分者盲法随机试验，纳入73例重度抑郁症患者。干预组（n = 35）患者在3个月内每天收到两次支持性短信，而对照组（n = 38）患者每两周收到一条感谢他们参与研究的短信。本研究的主要结局是：“贝克抑郁量表（BDI）得分相对于基线的平均变化”。
在对基线BDI得分进行调整后，干预组和对照组在3个月时的平均BDI得分仍存在显著差异：（20.8（标准差 = 11.7）对24.9（标准差 = 11.5），F（1, 60） = 4.83，p = 0.03，偏 eta 方 = 0.07）。BDI得分变化的平均差异具有统计学意义，效应量（科恩d值）为0.67。此外，在对基线得分进行调整后，干预组和对照组在3个月时的平均自评视觉模拟量表（VAS）得分（EQ - 5D - 5L量表）仍存在显著差异，分别为65.7（标准差 = 15.3）和57.4（标准差 = 22.9），F（1, 60） = 4.16，p = 0.05，偏 eta 方 = 0.065。自评VAS得分变化的平均差异也具有统计学意义，效应量（科恩d值）为0.51。
我们的研究结果表明，支持性短信是一种对抑郁症潜在有用的心理干预措施，尤其适用于服务不足的人群。需要进一步研究以探讨我们的研究结果在更大临床样本中的意义。
ClinicalTrials.gov NCT02327858。于2014年12月24日注册。
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