Toombs Maree, Nasir Bushra, Kisely Steve, Kondalsamy-Chennakesavan Srinivas, Hides Leanne, Gill Neeraj, Beccaria Gavin, Brennan-Olsen Sharon, Butten Kayley, Nicholson Geoffrey
Indigenous Health, Rural Clinical School, Faculty of Medicine, The University of Queensland, Australia.
Rural Clinical School, Faculty of Medicine, The University of Queensland, Australia.
BJPsych Open. 2020 Apr 6;6(3):e33. doi: 10.1192/bjo.2020.16.
A four- to seven-fold increase in the prevalence of current mood, anxiety, substance use and any mental disorders in Indigenous adults compared with non-Indigenous Australians has been reported. A lifetime prevalence of major depressive disorder was 23.9%. High rates of comorbid mental disorders indicated a transdiagnostic approach to treatment might be most appropriate. The effectiveness of psychological treatment for Indigenous Australians and adjunct Indigenous spiritual and cultural healing has not previously been evaluated in controlled clinical trials.
This project aims to develop, deliver and evaluate the effectiveness of an Indigenous model of mental healthcare (IMMHC). Trial registration: ANZCTR Registration Number: ACTRN12618001746224 and World Health Organization Universal Trial Number: U1111-1222-5849.
The IMMHC will be based on transdiagnostic cognitive-behaviour therapy co-designed with the Indigenous community to ensure it is socially and culturally appropriate for Indigenous Australians. The IMMHC will be evaluated in a randomised controlled trial with 110 Indigenous adults diagnosed with a current diagnosis of depression. The primary outcome will be the severity of depression symptoms as determined by changes in Beck Depression Inventory-II score at 6 months post-intervention. Secondary outcomes include anxiety, substance use disorder and quality of life. Outcomes will be assessed at baseline, 6 months post-intervention and 12 months post-intervention.
The study design adheres to the Consolidated Standards of Reporting Trials (CONSORT) statement recommendations and CONSORT extensions for pilot trials. We followed the Standard Protocol Items for Randomised Trials statement recommendations in writing the trial protocol.
This study will likely benefit participants, as well as collaborating Aboriginal Medical Services and health organisations. The transdiagnostic IMMHC has the potential to have a substantial impact on health services delivery in the Indigenous health sector.
据报道，与非澳大利亚原住民相比，澳大利亚原住民成年人当前情绪、焦虑、物质使用及任何精神障碍的患病率增加了4至7倍。重度抑郁症的终生患病率为23.9%。精神障碍的高共病率表明，采用跨诊断方法进行治疗可能最为合适。此前尚未在对照临床试验中评估针对澳大利亚原住民的心理治疗以及辅助的原住民精神和文化治疗的有效性。
本项目旨在开发、提供并评估一种原住民心理健康护理模式（IMMHC）的有效性。试验注册：澳大利亚新西兰临床试验注册中心注册号：ACTRN12618001746224，世界卫生组织通用试验编号：U1111-1222-5849。
IMMHC将基于与原住民社区共同设计的跨诊断认知行为疗法，以确保其在社会和文化层面适合澳大利亚原住民。将在一项随机对照试验中对110名被诊断为当前患有抑郁症的原住民成年人进行IMMHC评估。主要结局将是干预后6个月时贝克抑郁量表-II得分的变化所确定的抑郁症状严重程度。次要结局包括焦虑、物质使用障碍和生活质量。将在基线、干预后6个月和干预后12个月评估结局。
该研究设计遵循了试验报告的统一标准（CONSORT）声明建议以及针对试点试验的CONSORT扩展。我们在撰写试验方案时遵循了随机试验标准方案项目声明的建议。
本研究可能会使参与者以及合作的原住民医疗服务机构和卫生组织受益。跨诊断的IMMHC有可能对原住民卫生部门的医疗服务提供产生重大影响。
