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在 COVID-19 大流行和儿童心理健康危机期间,检查强化远程心理健康治疗对儿科焦虑和强迫症的疗效。

Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis.

机构信息

McLean Hospital Belmont, Belmont, MA, USA.

Harvard Medical School, Cambridge, MA, USA.

出版信息

Child Psychiatry Hum Dev. 2024 Oct;55(5):1398-1412. doi: 10.1007/s10578-023-01500-5. Epub 2023 Feb 7.

Abstract

Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.

摘要

尽管有研究支持每周门诊视频会议为基础的认知行为疗法(VCBT)的疗效,但利用 VCBT 进行简短强化治疗的益处证据有限。我们研究了针对儿童焦虑和强迫症的强化门诊 VCBT 的效果。采用准实验设计,比较了在大流行前强化、面对面、基于小组的认知行为疗法与药物管理和照顾者指导的治疗效果,以及大流行期间的类似 VCBT 治疗效果(n=130)。治疗前和治疗后评估包括患者和照顾者报告的焦虑和功能障碍。进行协方差分析,控制入院水平,比较治疗组之间的焦虑和障碍变化。治疗后焦虑或障碍无显著差异。这项研究表明,使用 VCBT 对儿童焦虑和强迫症进行强化、小组治疗与焦虑和障碍的减轻相关。这是为有需要的青少年提供更广泛获得优质护理的重要一步。

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JAMA Health Forum. 2022 May 6;3(5):e221684. doi: 10.1001/jamahealthforum.2022.1684.
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Impact of COVID-19 pandemic on mental health: An international study.新冠疫情对心理健康的影响:一项国际研究。
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