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在线心理健康干预对青少年是否有效?系统评价。

Are online mental health interventions for youth effective? A systematic review.

机构信息

Centre for Online Health, 1974The University of Queensland, Australia.

Centre for Health Services Research, 1974The University of Queensland, Australia.

出版信息

J Telemed Telecare. 2021 Dec;27(10):638-666. doi: 10.1177/1357633X211047285.

Abstract

OBJECTIVES

This systematic review aims to examine the effectiveness of online mental health interventions for youth.

METHODS

We searched seven electronic databases (PubMed, PsycINFO, Medline, Embase, CINAHL, Web of Science and SCOPUS) for the past 10 years to identify randomized controlled trials which have evaluated the use of telehealth interventions for young people with mental health problems. The included studies were assessed for quality and risk of bias.

RESULTS

Forty-five randomized controlled trials ( = 13,291 participants) were eligible for this review. Most studies (35 trials) evaluated the use of web-based self-help platforms to deliver cognitive behavioural therapy (14 trials), mindfulness (four trials), acceptance commitment therapy (five trials) and positive psychology (two trials). Mobile/computer applications were used to deliver cognitive behavioural therapy (four trials) and coping strategies training (two trials). Web-based synchronous chat (one trial) was used to assist communication between counsellors and participants. Three studies used artificial intelligence-based conversational agents to deliver cognitive behavioural therapy (two trials) and problem-solving-strategy training (one trial). Eighty-two percent ( = 37) identified the participants as student population (i.e. university students, high school students). Sixty-four percent ( = 29) of the telehealth interventions were found to be effective in managing depression, anxiety, stress, insomnia and improving quality of life when compared with control conditions.

CONCLUSIONS

Online mental health interventions were found to be effective in managing diverse mental health conditions among youth. Online self-help platforms were the most frequently used modality and artificial intelligence-based chatbots are merging as potential solutions. Future research is warranted to investigate the solutions to improve the retention rate and satisfaction of telehealth interventions among this population.

摘要

目的

本系统评价旨在考察针对青年的在线心理健康干预措施的有效性。

方法

我们在过去 10 年中搜索了 7 个电子数据库(PubMed、PsycINFO、Medline、Embase、CINAHL、Web of Science 和 SCOPUS),以确定评估远程医疗干预措施对有心理健康问题的年轻人使用情况的随机对照试验。纳入的研究进行了质量和偏倚风险评估。

结果

共有 45 项随机对照试验(n=13291 名参与者)符合本综述的纳入标准。大多数研究(35 项试验)评估了基于网络的自助平台在提供认知行为疗法(14 项试验)、正念(四项试验)、接纳承诺疗法(五项试验)和积极心理学(两项试验)方面的应用。移动/计算机应用程序用于提供认知行为疗法(四项试验)和应对策略训练(两项试验)。基于网络的同步聊天(一项试验)用于协助辅导员与参与者之间的沟通。三项研究使用基于人工智能的对话代理来提供认知行为疗法(两项试验)和解决问题策略训练(一项试验)。82%(n=37)的研究将参与者确定为学生群体(即大学生、高中生)。与对照条件相比,64%(n=29)的远程医疗干预措施在管理抑郁、焦虑、压力、失眠和提高生活质量方面被发现是有效的。

结论

在线心理健康干预措施被发现对管理青年的各种心理健康状况有效。在线自助平台是最常用的模式,基于人工智能的聊天机器人正在成为潜在的解决方案。未来的研究需要调查如何提高该人群对远程医疗干预措施的保留率和满意度。

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