Myrtveit Sæther Solbjørg Makalani, Knapstad Marit, Grey Nick, Rognerud Marit Aase, Smith Otto R F
Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes Gate 7, 5015, Bergen, Norway.
Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes Gate 7, 5015, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway.
Behav Res Ther. 2020 Dec;135:103758. doi: 10.1016/j.brat.2020.103758. Epub 2020 Oct 20.
Prompt Mental Health Care (PMHC, Norwegian adaptation of Improving Access to Psychological Therapies) is found successful in alleviating symptoms of anxiety and depression. Here, we investigate whether improvement is maintained over time. A randomized controlled trial was conducted in two PMHC sites from November 2015 to August 2017, randomly assigning 681 adults with anxiety and/or mild to moderate depression (70:30 ratio: PMHC n = 463, TAU n = 218). Main outcomes were recovery rates and changes in symptoms of depression and anxiety from baseline to 12 months. Secondary outcomes were functional status, health-related quality of life, mental wellbeing and work participation. At 12 months after baseline the reliable recovery rate was 59.4% in PMHC and 36.6% in TAU, giving a between-group effect size of 0.51 (95%CI: 0.26, 0.77, p < 0.001). Differences in symptom change gave between-group effect sizes of -0.67 (95%CI: -0.99, -0.36, p < 0.001) for depression and -0.58 (95%CI: -0.91, -0.26, p < 0.001) for anxiety. PMHC was also at 12 months found more effective in improving functional status, health-related quality of life and mental wellbeing, but not work participation. In sum, substantial treatment effects of PMHC remain at 12 months follow-up, although results should be interpreted with caution due to risk of attrition bias.
快速心理治疗（PMHC，挪威对改善心理治疗可及性的改编版）在缓解焦虑和抑郁症状方面被证明是成功的。在此，我们调查这种改善是否能随时间持续。2015年11月至2017年8月在两个PMHC地点进行了一项随机对照试验，将681名患有焦虑和/或轻度至中度抑郁的成年人随机分组（比例为70:30：PMHC组n = 463，常规治疗组n = 218）。主要结局是康复率以及从基线到12个月时抑郁和焦虑症状的变化。次要结局是功能状态、健康相关生活质量、心理健康和工作参与度。在基线后12个月时，PMHC组的可靠康复率为59.4%，常规治疗组为36.6%，组间效应量为0.51（95%CI：0.26，0.77，p < 0.001）。症状变化的差异导致抑郁的组间效应量为 -0.67（95%CI：-0.99，-0.36，p < 0.001），焦虑的组间效应量为 -0.58（95%CI：-0.91，-0.26，p < 0.001）。在12个月时还发现PMHC在改善功能状态、健康相关生活质量和心理健康方面更有效，但在工作参与度方面则不然。总之，尽管由于失访偏倚风险，结果应谨慎解释，但在12个月的随访中PMHC仍有显著的治疗效果。
