a Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research , Ramón de la Fuente Muñiz National Institute of Psychiatry , Mexico City , Mexico.
Subst Use Misuse. 2018 Nov 10;53(13):2220-2231. doi: 10.1080/10826084.2018.1467452. Epub 2018 May 16.
Web-based cognitive-behavioral interventions to reduce substance use can be a useful low-cost treatment for a large number of people, and an attractive option in countries where a greater availability of treatment is needed.
To evaluate the feasibility and initial effectiveness of a web-based cognitive-behavioral intervention for the reduction of substance use and depression compared with treatment as usual, with and without a printed self-help manual.
Individuals seeking outpatient treatment for substance use were randomly assigned to one of the following: (1) the web-based Help Program for Drug Abuse and Depression (n = 23); (2) an in-person session with an addiction therapist and use of the Alcohol, Smoking, and Substance Involvement Screening Test Self-Help Strategies guide, followed by treatment as usual (n = 25), or (3) treatment ordinarily offered in the participating treatment centers (n = 26). The study took place in 2013-2014 (trial registration: ISRCTN25429892), and participants completed baseline, posttreatment, and 1-month follow-up evaluation interviews.
Treatment retention and data availability were comparable in all three conditions. A reduction was observed from baseline to follow-up in average days of use [F(1,28) = 29.70, p < 0.001], severity of use [F(2,28) = 143.66, p < 0.001], and depressive symptomatology [F = (4)16.40, p < 0.001], independent of the type of treatment provided.
The findings suggest that the web-based intervention to reduce substance abuse is feasible, although it is not more effective than other intervention modalities; its effectiveness must be evaluated in a larger sample. Attrition was a main limitation; future studies must improve retention and assess cost-effectiveness.
基于网络的认知行为干预措施可作为一种低成本的治疗方法，用于大量人群，并且在需要更多治疗方法的国家中，这也是一种很有吸引力的选择。
评估基于网络的认知行为干预措施在减少物质使用和抑郁方面的可行性和初步效果，与常规治疗相比，同时评估有无印刷自助手册的情况。
随机将寻求门诊治疗物质使用的个体分配到以下三种情况之一：（1）基于网络的《药物滥用与抑郁自助计划》（n = 23）；（2）与成瘾治疗师面谈并使用《酒精、吸烟和物质使用筛查测试自助策略指南》，然后接受常规治疗（n = 25），或（3）在参与治疗中心接受常规治疗（n = 26）。研究于 2013-2014 年进行（试验注册：ISRCTN25429892），参与者完成基线、治疗后和 1 个月随访评估访谈。
在所有三种情况下，治疗保留率和数据可用性都相当。与基线相比，使用天数的平均值（F（1，28）= 29.70，p < 0.001）、使用严重程度（F（2，28）= 143.66，p < 0.001）和抑郁症状严重程度（F = 16.40，p < 0.001）在随访时均有下降，而与所提供的治疗类型无关。
这些发现表明，减少物质滥用的基于网络的干预措施是可行的，尽管它不如其他干预方式有效；必须在更大的样本中评估其有效性。失访是一个主要限制；未来的研究必须提高保留率并评估成本效益。
