Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA.
Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA.
Behav Res Ther. 2021 Dec;147:103972. doi: 10.1016/j.brat.2021.103972. Epub 2021 Sep 24.
A large number of trials have consistently shown that guided digital mental health treatments (DMHTs) are effective for depression and anxiety. As DMHTs are adopted by healthcare organizations, payers, and employers, they are often considered most appropriate for people with mild-to-moderate levels of symptom severity. Thus, the aim of this study was to examine the effects of symptom severity on depression and anxiety outcomes and app use across three trials of a guided DMHT, IntelliCare. Participants were categorized into mild, moderate, moderately severe, and severe symptom severity groups on depression and anxiety. All symptom severity groups showed significant reductions in depression and anxiety in a clear ordinal pattern, with the mild symptom severity group showing the smallest changes and the severe symptom group showing the largest improvements. Those with the lowest levels of educational attainment showed the largest symptom improvement. Baseline symptom severity was not significantly related to app use. App use was significantly related to depression and anxiety outcomes. These findings suggest that depression and anxiety symptom severity is not useful in determining who should be referred to a guided DMHT.
大量研究一致表明，引导式数字心理健康治疗（DMHT）对抑郁和焦虑症有效。随着 DMHT 在医疗保健组织、支付方和雇主中得到采用，它们通常被认为最适合症状轻度至中度的人群。因此，本研究旨在探讨症状严重程度对引导式 DMHT——IntelliCare 的抑郁和焦虑结果以及应用程序使用的影响。在对 IntelliCare 的三项试验中，参与者根据抑郁和焦虑症状分为轻度、中度、中度严重和重度症状严重程度组。所有症状严重程度组在抑郁和焦虑方面均呈现出显著降低，且呈明显的有序模式，其中轻度症状严重程度组的变化最小，重度症状严重程度组的改善最大。受教育程度最低的人表现出最大的症状改善。基线症状严重程度与应用程序使用无显著相关性。应用程序使用与抑郁和焦虑结果显著相关。这些发现表明，抑郁和焦虑症状严重程度在确定谁应被转介至引导式 DMHT 方面并不有用。
