Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Occupational Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Telemed Telecare. 2024 Oct;30(9):1376-1385. doi: 10.1177/1357633X231151788. Epub 2023 Feb 16.
In-person cognitive behavioral therapy (CBT) can reduce self-reported anxiety in older adults. However, studies are limited for remote CBT. We assessed the effectiveness of remote CBT in mitigating self-reported anxiety in older adults.
We conducted a systematic review and meta-analysis based on a literature search of PubMed, Embase, PsycInfo, and Cochrane databases up to March 31, 2021, for randomized controlled clinical trials comparing the effectiveness of remote CBT versus non-CBT controls on mitigating self-reported anxiety in older adults. We calculated within-group pre-to-post-treatment standardized mean difference using Cohen's , obtained the difference between a remote CBT group and a non-CBT control group as our effect size for cross-study comparison, and conducted a random-effects meta-analysis. Changes in scores on self-reported anxiety symptoms (Generalized Anxiety Disorder-7 item Scale, Penn State Worry Questionnaire, or Penn State Worry Questionnaire - Abbreviated), and self-reported depressive symptoms (Patient Health Questionnaire-9 item Scale or Beck Depression Inventory) were primary and secondary outcomes, respectively.
Six eligible studies, containing 633 participants with a pooled mean age of 66.6 years, were included in the systematic review and meta-analysis. There was a significant mitigating effect of intervention on self-reported anxiety, favoring remote CBT over non-CBT controls (between-group effect size: -0.63; 95% CI: -0.99 to -0.28). We also found a significant mitigating effect of intervention on self-reported depressive symptoms (between-group effect size: -0.74; 95% CI: -1.24 to -0.25).
Remote CBT is more effective in reducing self-reported anxiety and depressive symptoms than non-CBT control in older adults.
面对面认知行为疗法（CBT）可以减轻老年人的自我报告焦虑。然而，远程 CBT 的研究有限。我们评估了远程 CBT 在减轻老年人自我报告焦虑中的有效性。
我们进行了系统评价和荟萃分析，基于对截至 2021 年 3 月 31 日PubMed、Embase、PsycInfo 和 Cochrane 数据库的文献检索，比较了远程 CBT 与非 CBT 对照组在减轻老年人自我报告焦虑方面的有效性。我们使用 Cohen's 计算了组内治疗前后标准化均数差值，获得了远程 CBT 组与非 CBT 对照组之间的差值作为跨研究比较的效应量，并进行了随机效应荟萃分析。自我报告的焦虑症状（广泛性焦虑障碍-7 项量表、宾夕法尼亚州担忧问卷或宾夕法尼亚州担忧问卷-缩写）和自我报告的抑郁症状（患者健康问卷-9 项量表或贝克抑郁量表）的变化分别是主要和次要结局。
六项符合条件的研究，包含 633 名平均年龄为 66.6 岁的参与者，被纳入系统评价和荟萃分析。干预对自我报告的焦虑有显著的缓解作用，远程 CBT 优于非 CBT 对照组（组间效应量：-0.63；95%CI：-0.99 至-0.28）。我们还发现干预对自我报告的抑郁症状有显著的缓解作用（组间效应量：-0.74；95%CI：-1.24 至-0.25）。
远程 CBT 在减轻老年人的自我报告焦虑和抑郁症状方面比非 CBT 对照组更有效。
