1 School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
2 South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
J Telemed Telecare. 2019 Apr;25(3):131-141. doi: 10.1177/1357633X17748991. Epub 2018 Jan 8.
Mental health interventions disseminated via, or accessed using, digital technologies are an innovative new treatment modality for managing co-morbid depression and substance use disorder. The present systematic review assessed the current state of this literature.
A search of the Cochrane Library, Embase, Pubmed, PsycInfo and Scopus databases identified six eligible studies ( N = 862), utilising quasi-experimental or randomised controlled designs. Reporting quality was evaluated and Hedges' g effect sizes (with 95% confidence intervals and p-values) were calculated to determine treatment effectiveness. Process outcomes (e.g. treatment satisfaction, attrition rates) were also examined.
Quality ratings demonstrated high internal validity, although external validity was low. Effect size data revealed medium to large and short-term improvements in severity of depression and substance use symptoms in addition to global improvement in social, occupational and psychological functioning. Longer-term treatment effectiveness could not be established, due to the limited available data. Preliminary findings suggest that there was high client satisfaction, therapeutic alliance and client engagement.
Mobile phone devices and the Internet can help to increase access to care for those with mental health co-morbidity. Large-scale and longitudinal research is, however, needed before digital mental healthcare becomes standard practice. This includes establishing critical therapeutic factors including optimum levels of assistance from clinicians.
通过数字技术传播或使用的心理健康干预措施是一种用于管理共病性抑郁和物质使用障碍的创新新治疗方法。本系统评价评估了该文献的现状。
对 Cochrane 图书馆、Embase、Pubmed、PsycInfo 和 Scopus 数据库进行了检索，确定了六项符合条件的研究（N=862），这些研究采用了准实验或随机对照设计。评估了报告质量，并计算了 Hedges'g 效应大小（置信区间和 p 值），以确定治疗效果。还检查了过程结果（例如治疗满意度、失访率）。
质量评级显示出较高的内部有效性，尽管外部有效性较低。效应量数据显示，抑郁和物质使用症状的严重程度以及社会、职业和心理功能的总体改善均有中等到较大和短期的改善。由于可用数据有限，无法确定长期治疗效果。初步结果表明，患者满意度、治疗联盟和患者参与度较高。
移动电话设备和互联网可以帮助增加对患有精神健康共病患者的治疗机会。然而，在数字心理健康护理成为标准实践之前，需要进行大规模和长期的研究。这包括确定关键的治疗因素，包括临床医生提供的最佳帮助水平。
