面对面与基于互联网的认知行为疗法治疗广泛性焦虑症的比较疗效：一项随机对照试验的荟萃分析
Comparative efficacy of face-to-face and internet-based cognitive behavior therapy for generalized anxiety disorder: A meta-analysis of randomized controlled trial.
作者信息
Zhang Wenle, Du Yun, Yang Xiangyun, Wang Encong, Fang Jiexin, Liu Ziqi, Wu Shanqian, Liu Qinqin, Hu Yongdong
机构信息
Department of Psychological Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Clinical Psychology, Capital Medical University, Beijing, China.
出版信息
Front Psychiatry. 2022 Jul 28;13:832167. doi: 10.3389/fpsyt.2022.832167. eCollection 2022.
OBJECTIVE
The study aimed to ascertain the comparative efficacy of these two forms on reducing anxiety scores of scales in patients with a generalized anxiety disorder (GAD) by examining the available evidence for face-to-face cognitive behavior therapy (CBT) and internet-based cognitive behavior therapy (ICBT). Moreover, this study attempted to determine whether ICBT can obtain similar benefits as CBT for GAD patients during coronavirus disease 2019 (COVID-19) due to the quarantine policy and the requirement of social distance.
METHODS
This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (registration number CRD42021241938). Therefore, a meta-analysis of randomized controlled trials (RCTs) examining CBT or ICBT was conducted in this study to treat GAD patients diagnosed with DMS-IV. The researchers searched PubMed, MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews for relevant studies published from 2000 to July 5, 2022. Evidence from RCTs was synthesized by Review Manager 5.4 as mean difference (MD) for change in scores of scales through a random-effects meta-analysis.
RESULTS
A total of 26 trials representing 1,687 participants were pooled. The results demonstrated that ICBT and CBT were very close in the effect size of treating GAD (MD = -2.35 vs. MD = -2.79). Moreover, they still exhibited a similar response (MD = -3.45 vs. MD = -2.91) after studies with active control were removed.
CONCLUSION
Regarding the treatment of GAD, ICBT can achieve a similar therapeutic effect as CBT and could be CBT's candidate substitute, especially in the COVID-19 pandemic era, since the internet plays a crucial role in handling social space constraints.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=241938, identifier CRD42021241938.
目的
本研究旨在通过审查面对面认知行为疗法（CBT）和基于互联网的认知行为疗法（ICBT）的现有证据，确定这两种形式在降低广泛性焦虑症（GAD）患者焦虑量表评分方面的比较疗效。此外，由于2019年冠状病毒病（COVID-19）期间的隔离政策和社交距离要求，本研究试图确定ICBT对GAD患者是否能获得与CBT类似的益处。
方法
根据系统评价和Meta分析优先报告条目声明中的指南，本Meta分析在国际前瞻性系统评价注册库（PROSPERO）进行了注册（注册号CRD42021241938）。因此，本研究对检查CBT或ICBT治疗诊断为DMS-IV的GAD患者的随机对照试验（RCT）进行了Meta分析。研究人员在PubMed、MEDLINE、Embase、PsycINFO和Cochrane系统评价数据库中检索了2000年至2022年7月5日发表的相关研究。通过随机效应Meta分析，由Review Manager 5.4将RCT的证据合成为量表评分变化的平均差（MD）。
结果
共纳入了代表1687名参与者的26项试验。结果表明，ICBT和CBT在治疗GAD的效应大小上非常接近（MD = -2.35对MD = -2.79）。此外，在剔除有活性对照的研究后，它们仍表现出相似的反应（MD = -3.45对MD = -2.91）。
结论
在GAD的治疗方面，ICBT可以达到与CBT相似的治疗效果，并且可以成为CBT的替代选择，特别是在COVID-19大流行时代，因为互联网在应对社会空间限制方面发挥着至关重要的作用。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=241938，标识符CRD42021241938。
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