Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Psychother Psychosom. 2021;90(3):191-199. doi: 10.1159/000512843. Epub 2020 Nov 19.
Worries about the immediate and long-term consequences of the COVID-19 pandemic may for some individuals develop into pervasive worry that is disproportionate in its intensity or duration and significantly interferes with everyday life.
The aim of this study was to investigate if a brief self-guided, online psychological intervention can reduce the degree of dysfunctional worry related to the COVID-19 pandemic and associated symptoms.
670 adults from the Swedish general population reporting daily uncontrollable worry about CO-VID-19 and its possible consequences (e.g., illness, death, the economy, one's family) were randomised (1:1 ratio) to a 3-week self-guided, online cognitive behavioural intervention targeting dysfunctional COVID-19 worry and associated symptoms, or a waiting list of equal duration. The primary outcome measure was a COVID-19 adapted version of the Generalised Anxiety Disorder 7-item scale administered at baseline and weeks 1-3 (primary endpoint). Follow-up assessments were conducted 1 month after treatment completion. The trial was registered on ClinicalTrials.gov (NCT04341922) before inclusion of the first participant.
The main pre-specified intention-to-treat analysis indicated significant reductions in COVID-19-related worry for the intervention group compared to the waiting list (β = 1.14, Z = 9.27, p < 0.001), corresponding to a medium effect size (bootstrapped d = 0.74 [95% CI: 0.58-0.90]). Improvements were also seen on all secondary measures, including mood, daily functioning, insomnia, and intolerance of uncertainty. Participant satisfaction was high. No serious adverse events were recorded.
A brief digital and easily scalable self-guided psychological intervention can significantly reduce dysfunctional worry and associated behavioural symptoms related to the COVID-19 pandemic.
由于对 COVID-19 大流行的直接和长期后果的担忧，一些人可能会发展为过度担忧，其强度或持续时间不成比例，并严重干扰日常生活。
本研究旨在调查简短的自我引导、在线心理干预是否可以减轻与 COVID-19 大流行相关的功能失调性担忧及其相关症状的程度。
670 名来自瑞典普通人群的成年人报告每天对 COVID-19 及其可能的后果（例如疾病、死亡、经济、家庭）无法控制的担忧，他们被随机（1:1 比例）分为 3 周的自我引导、在线认知行为干预组，针对功能失调性 COVID-19 担忧及其相关症状，或等待时间相等。主要结局测量是在基线和第 1-3 周（主要终点）进行 COVID-19 适应的广泛性焦虑症 7 项量表。治疗完成后 1 个月进行随访评估。该试验在纳入第一个参与者之前在 ClinicalTrials.gov（NCT04341922）上进行了注册。
主要的预先指定的意向治疗分析表明，与等待名单相比，干预组的 COVID-19 相关担忧显著减少（β=1.14，Z=9.27，p<0.001），对应于中等效应大小（bootstrapped d=0.74 [95%CI：0.58-0.90]）。在所有次要测量中也观察到了改善，包括情绪、日常功能、失眠和对不确定性的容忍度。参与者满意度很高。没有记录到严重不良事件。
简短的数字和易于扩展的自我引导心理干预可以显著减轻与 COVID-19 大流行相关的功能失调性担忧及其相关行为症状。
