Berryhill M Blake, Halli-Tierney Anne, Culmer Nathan, Williams Nelle, Betancourt Alex, King Michael, Ruggles Hannah
Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, AL, USA.
College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, USA.
Fam Pract. 2019 Jan 25;36(1):53-63. doi: 10.1093/fampra/cmy072.
The growing worldwide prevalence of individuals with anxiety disorders has increased needs for mental health services. Due to limited number of mental health providers and community resources, especially in low-income countries, individuals often seek services from primary care settings. Through collaborative care models, services via telemedicine address the mental health provider shortage. While previous reviews show telemedicine effectively treats mental illness, a gap exists for reviews on videoconferencing psychological therapy for anxiety treatment.
This systematic review aims to summarize videoconferencing psychological therapy for anxiety disorder treatment.
Database searches were performed with PubMed, PsychINFO and Embase. Inclusion criteria identified controlled and uncontrolled studies evaluating videoconferencing psychological therapy. Studies were appraised using the Effective Public Health Practice Project Quality Assessment tool. Data collected included research design, sample size, intervention details, outcome results, intervention effect size and differences between videoconferencing psychological therapy and face-to-face therapy.
The search revealed 1253 articles, with 21 meeting inclusion criteria. Sample sizes ranged from 1 to 121 participants; cognitive-behavioral therapy was most commonly evaluated. Participants' diagnoses included panic disorder with and without agoraphobia, generalized anxiety disorder, social anxiety disorder, social phobia and hypochondriasis. Three studies occurred in outpatient health care settings. Fourteen studies reported statistically significant improvement on anxiety measures; 11 reported clinically significant improvements. Effect sizes ranged from small to very large, and all controlled studies found no differences between videoconferencing and face-to face groups.
Results provide promise for evidence-based interventions delivered via videoconferencing psychological therapy. More rigorous research is needed in various settings and populations.
全球焦虑症患者患病率不断上升，对心理健康服务的需求也随之增加。由于心理健康服务提供者和社区资源数量有限，尤其是在低收入国家，患者常常在初级保健机构寻求服务。通过协作护理模式，远程医疗服务可解决心理健康服务提供者短缺的问题。虽然此前的综述表明远程医疗能有效治疗精神疾病，但关于视频会议心理治疗焦虑症的综述仍存在空白。
本系统综述旨在总结视频会议心理治疗焦虑症的情况。
通过PubMed、PsychINFO和Embase进行数据库检索。纳入标准为评估视频会议心理治疗的对照研究和非对照研究。使用有效公共卫生实践项目质量评估工具对研究进行评价。收集的数据包括研究设计、样本量、干预细节、结果、干预效应大小以及视频会议心理治疗与面对面治疗之间的差异。
检索共找到1253篇文章，其中21篇符合纳入标准。样本量从1名到121名参与者不等；最常评估的是认知行为疗法。参与者的诊断包括伴或不伴广场恐惧症的惊恐障碍、广泛性焦虑症、社交焦虑症、社交恐惧症和疑病症。三项研究在门诊医疗环境中进行。十四项研究报告焦虑测量指标有统计学显著改善；十一项报告有临床显著改善。效应大小从小到非常大不等，所有对照研究均发现视频会议组与面对面组之间无差异。
研究结果为通过视频会议心理治疗提供循证干预带来了希望。需要在不同环境和人群中开展更严格的研究。
