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新冠疫情期间,使用远程医疗治疗重度抑郁症患者:与疫情前的面对面治疗相比,其安全性、患者满意度和疗效相当。

Telehealth treatment of patients with major depressive disorder during the COVID-19 pandemic: Comparative safety, patient satisfaction, and effectiveness to prepandemic in-person treatment.

机构信息

Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States.

Department of Psychiatry and Human Behavior, Brown Medical School, Rhode Island Hospital, Providence, RI, United States.

出版信息

J Affect Disord. 2023 Feb 15;323:624-630. doi: 10.1016/j.jad.2022.12.015. Epub 2022 Dec 12.

Abstract

BACKGROUND

The COVID-19 pandemic impelled a transition from in-person to telehealth psychiatric treatment. There are no studies of partial hospital telehealth treatment for major depressive disorder (MDD). In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the effectiveness of partial hospital care of patients with MDD treated virtually versus in-person.

METHODS

Outcome was compared in 294 patients who were treated virtually from May 2020 to December 2021 to 542 patients who were treated in the in-person partial program in the 2 years prior to the pandemic. Patients completed self-administered measures of patient satisfaction, symptoms, coping ability, functioning, and general well-being.

RESULTS

In both the in-person and telehealth groups, patients with MDD were highly satisfied with treatment and reported a significant reduction in symptoms from admission to discharge. Both groups also reported a significant improvement in positive mental health, general well-being, coping ability, and functioning. A large effect size of treatment was found in both treatment groups. Contrary to our hypothesis, the small differences in outcome favored the telehealth-treated patients. The length of stay and the likelihood of staying in treatment until completion were significantly greater in the virtually treated patients.

LIMITATIONS

The treatment groups were ascertained sequentially, and telehealth treatment was initiated after the COVID-19 pandemic began. Outcome assessment was limited to a self-administered questionnaire.

CONCLUSIONS

In an intensive acute care setting, delivering treatment to patients with MDD using a virtual, telehealth platform was as effective as treating patients in-person.

摘要

背景

COVID-19 大流行促使精神科治疗从线下转为线上。目前尚未有针对重度抑郁症(MDD)的部分住院线上治疗的研究。在罗德岛改善诊断评估和服务(MIDAS)项目的本报告中,我们比较了虚拟治疗与面对面治疗 MDD 患者的部分住院治疗效果。

方法

比较了 2020 年 5 月至 2021 年 12 月期间接受虚拟治疗的 294 名 MDD 患者与大流行前 2 年接受面对面部分项目治疗的 542 名患者的治疗效果。患者完成了自我评估的患者满意度、症状、应对能力、功能和总体幸福感的量表。

结果

面对面组和线上组的 MDD 患者对治疗都非常满意,并报告了从入院到出院的症状显著减轻。两组患者的心理健康状况、总体幸福感、应对能力和功能均有显著改善。两组患者均发现治疗效果的效应量较大。与我们的假设相反,线上治疗患者的结果差异较小。虚拟治疗患者的住院时间和完成治疗的可能性显著增加。

局限性

治疗组是顺序确定的,并且线上治疗是在 COVID-19 大流行开始后才开始的。结果评估仅限于自我评估问卷。

结论

在强化急性治疗环境中,使用虚拟的线上平台为 MDD 患者提供治疗与面对面治疗一样有效。

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