Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
J Anxiety Disord. 2021 Apr;79:102385. doi: 10.1016/j.janxdis.2021.102385. Epub 2021 Mar 16.
Cognitive behavioral therapy (CBT) is an established treatment for panic disorder (PD). Remote CBT (RCBT) is becoming increasingly popular and has the potential to enhance access to this treatment. The aim of this study was to examine the efficacy of RCBT for PD using a meta-analytic approach. An electronic database search was used to identify relevant articles and the references of previously completed reviews. Twenty-one studies (n = 1,604; mean age range: 31.9-43.9; mean female representation = 71 %) were included in the meta-analysis. 14/21 (67 %; n = 817 of the included studies were randomised controlled trials and 7/21 (33 %; n = 787) were open trials or non-randomised controlled trials. Pooled within-group effect sizes across all remote treatments for PD symptoms were large from pre-treatment to post-treatment (Hedges' g = 1.18; 95 % CI: 0.99-1.36) and pre-treatment to follow-up (Hedges' g = 1.51; 95 % CI: 1.22-1.79). Pooled between-group findings indicate that remote CBT treatments are more effective than passive control (Hedges' g = 1.17; 95 % CI: 0.85-1.50), but are similar to other active treatments on measures of PD symptoms (e.g., face-to-face CBT) (Hedges' g = 0.02; 95 % CI: -0.43 to 0.48). Internet-delivered CBT (Hedges' g = 1.10, 95 % CI: 0.91-1.30), videoconferencing-delivered CBT (Hedges' g = 1.40, 95 % CI: 0.85-1.95) and bibliotherapy-delivered CBT (Hedges' g = 1.51, 95 % CI: 0.95-2.06) each produce large effect sizes on measures of PD symptoms. The results have important implications for the dissemination of entirely remote stepped-care treatments for PD.
认知行为疗法（CBT）是一种已被确立的治疗惊恐障碍（PD）的方法。远程认知行为疗法（RCBT）越来越受欢迎，并有潜力增加这种治疗方法的可及性。本研究旨在通过元分析方法来评估远程认知行为疗法治疗 PD 的疗效。使用电子数据库搜索来确定相关文章，并查阅之前完成的综述的参考文献。共有 21 项研究（n=1604；平均年龄范围：31.9-43.9；平均女性占比=71%）被纳入元分析。21 项研究中有 14 项（67%；n=817 项研究为随机对照试验，7 项（33%；n=787 项为开放试验或非随机对照试验。所有远程治疗 PD 症状的组内效应大小从治疗前到治疗后均较大（Hedges' g=1.18；95%CI：0.99-1.36），从治疗前到随访时也较大（Hedges' g=1.51；95%CI：1.22-1.79）。组间发现表明，远程认知行为疗法治疗比被动对照更有效（Hedges' g=1.17；95%CI：0.85-1.50），但与其他主动治疗 PD 症状的治疗（如面对面认知行为疗法）相似（Hedges' g=0.02；95%CI：-0.43 至 0.48）。互联网提供的认知行为疗法（Hedges' g=1.10，95%CI：0.91-1.30）、视频会议提供的认知行为疗法（Hedges' g=1.40，95%CI：0.85-1.95）和自助认知行为疗法（Hedges' g=1.51，95%CI：0.95-2.06）在 PD 症状测量上均产生较大的效应量。这些结果对完全远程分步治疗 PD 的传播具有重要意义。
