Forman-Hoffman Valerie L, Nelson Benjamin W, Ranta Kristian, Nazander Albert, Hilgert Outi, de Quevedo Joao
Meru Health Inc., San Mateo, CA, USA.
University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, USA.
Internet Interv. 2021 Jun 17;25:100408. doi: 10.1016/j.invent.2021.100408. eCollection 2021 Sep.
Depression is a debilitating disorder associated with poor health outcomes, including increased comorbidity and early mortality. Despite the advent of new digital health interventions, few have been tested among patients with more severe forms of depression. As such, in an intent-to-treat study we examined whether 218 patients with at least moderately severe depressive symptoms (PHQ-9 ≥ 15) experienced significant reductions in depressive symptoms after participation in a therapist-supported, evidence-based mobile health (mHealth) program, Meru Health Program (MHP). Patients with moderately severe and severe depressive symptoms at pre-program assessment experienced significant decreases in depressive symptoms at end-of treatment (mean [standard deviation] PHQ-9 reduction = 8.30 [5.03], Hedges' = 1.64, 95% CI [1.44, 1.85]). Also, 34% of patients with at least moderately severe depressive symptoms at baseline and 29.9% of patients with severe depressive symptoms (PHQ-9 ≥ 20) at baseline responded to the intervention at end-of-treatment, defined as experiencing ≥50% reduction in PHQ-9 score and a post-program PHQ-9 score lower than 10. Limitations include use lack of a control group and no clinical diagnostic information. Future randomized trials are warranted to test the MHP as a scalable solution for patients with more severe depressive symptoms.
抑郁症是一种使人衰弱的疾病,与不良健康结果相关,包括合并症增加和过早死亡。尽管出现了新的数字健康干预措施,但在更严重形式的抑郁症患者中进行测试的却很少。因此,在一项意向性治疗研究中,我们调查了218名至少有中度严重抑郁症状(患者健康问卷-9≥15)的患者在参与一项由治疗师支持的、基于证据的移动健康(mHealth)项目——梅鲁健康项目(MHP)后,抑郁症状是否有显著减轻。在项目前评估中患有中度严重和严重抑郁症状的患者在治疗结束时抑郁症状有显著减轻(平均[标准差]患者健康问卷-9降低=8.30[5.03],赫奇斯效应量=1.64,95%置信区间[1.44,1.85])。此外,基线时至少有中度严重抑郁症状的患者中有34%以及基线时患有严重抑郁症状(患者健康问卷-9≥20)的患者中有29.9%在治疗结束时对干预有反应,定义为患者健康问卷-9得分降低≥50%且项目后患者健康问卷-9得分低于10。局限性包括缺乏对照组以及没有临床诊断信息。未来有必要进行随机试验,以测试MHP作为针对更严重抑郁症状患者的可扩展解决方案。