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心境 swings 2.0 的随机对照试验:一种基于互联网的双相情感障碍自我管理方案。

A randomized controlled trial of MoodSwings 2.0: An internet-based self-management program for bipolar disorder.

机构信息

IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.

Department of Psychiatry, University of Melbourne, Parkville, Australia.

出版信息

Bipolar Disord. 2019 Feb;21(1):28-39. doi: 10.1111/bdi.12669. Epub 2018 Jun 21.

Abstract

OBJECTIVES

MoodSwings 2.0 is an online self-guided intervention for bipolar disorder that includes educational modules, interactive tools, and discussion forums. The primary aim of the study was to determine if participation in MoodSwings 2.0 would result in decreased symptoms of depression and mania compared to the control condition. Secondary aims were to identify improvements in core depression symptoms, quality of life, medication adherence, functioning, and time to relapse.

METHODS

This was a three-arm randomized controlled trial that compared two intervention arms against a peer support control group (forum). A total of 304 adults aged 21 to 65 years with a diagnosis of bipolar disorder were assigned to a forum-only control group (Group 1; n = 102), a forum plus modules treatment group (Group 2; n = 102), or a forum, modules, and tools treatment group (Group 3; n = 100), in addition to usual care.

RESULTS

There was a significant intervention impact showing improvement on the primary outcome of depression for Group 2 compared to Group 1 (P = .05) with effect sizes (Cohen's d) ranging from 0.17 to 0.43. There was also a significant intervention impact showing improvement on the secondary outcome of core depression for Group 2 (P = .02) and Group 3 (P = .05), but worse physical functioning for Group 3 (P = .01), compared to Group 1.

CONCLUSIONS

This study provides evidence of the efficacy of internet-based psychoeducation interventions for bipolar disorder in reducing depressive symptoms. Further investigation is needed to assess effectiveness in a public program.

摘要

目的

MoodSwings 2.0 是一种针对双相情感障碍的在线自我引导干预措施,包括教育模块、互动工具和讨论论坛。该研究的主要目的是确定与对照组相比,参与 MoodSwings 2.0 是否会导致抑郁和躁狂症状减轻。次要目标是确定核心抑郁症状、生活质量、药物依从性、功能和复发时间的改善。

方法

这是一项三臂随机对照试验,比较了两种干预组与同伴支持对照组(论坛)。共有 304 名年龄在 21 至 65 岁之间、诊断为双相情感障碍的成年人被分配到仅论坛对照组(第 1 组;n=102)、论坛加模块治疗组(第 2 组;n=102)或论坛、模块和工具治疗组(第 3 组;n=100),同时接受常规护理。

结果

干预组对抑郁的主要结局有显著影响,与第 1 组相比,第 2 组有改善(P=.05),效应大小(Cohen's d)范围为 0.17 至 0.43。干预组对核心抑郁的次要结局也有显著影响,第 2 组(P=.02)和第 3 组(P=.05)均有改善,但第 3 组的身体功能恶化(P=.01),与第 1 组相比。

结论

本研究为基于互联网的双相情感障碍心理教育干预措施在减轻抑郁症状方面的疗效提供了证据。需要进一步研究来评估在公共项目中的有效性。

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