Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Psychiatr Ment Health Nurs. 2023 Oct;30(5):885-898. doi: 10.1111/jpm.12924. Epub 2023 Apr 3.
Depression is a leading cause of disability worldwide that negatively impacts quality of life. Talk therapy such as cognitive behavioural therapy is an effective treatment for depression. The Internet is an important tool for mental healthcare delivery. Internet-delivered or online talk therapy interventions are associated with lower costs and improved accessibility. Current reviews do not address the effectiveness of Internet-delivered cognitive behavioural therapy (iCBT) on quality of life (QoL).
Interventions for iCBT have better QoL improvements for individuals with greater depressive symptom severity, females, young adults and individuals with complex comorbid disorders. Support from a healthcare provider for iCBT interventions have better outcomes than self-guided therapy interventions. Tailoring the iCBT intervention to the specialized needs of the population is beneficial.
There is potential to address treatment gaps for managing the care of individuals with depression. Utilizing iCBT promotes the integration of accessible mental healthcare in clinical settings. Healthcare providers can have a more comprehensive approach to delivering iCBT by considering adaptations relevant to the clinical population being treated.
INTRODUCTION: Major depressive disorder (MDD) is a leading cause of disability resulting from social, psychological and biological factors affecting quality of life (QoL). Cognitive behavioural therapy (CBT) is an effective psychotherapy for MDD. Internet-delivered CBT (iCBT) is associated with lower costs and improved accessibility.
We aimed to examine the effectiveness of iCBT on QoL in adults with depression.
PubMed, Embase and PsycINFO were searched between 2010 and 2022. Inclusion criteria were experimental designs, adults ≥18 years old, depression diagnosis or valid self-report measure, iCBT intervention; and QoL outcome. Exclusion criteria were studies without depression analysis and intellectual disabilities or psychosis.
Seventeen articles were included, with a negative correlation between depression severity and QoL. Sex, age and physical comorbidity positively influenced effectiveness. Depressive severity, dysfunctional attitude and negative thinking were predictors and moderators of QoL. Clinician support can impact social interactions and sense of belonging.
Internet-delivered cognitive behavioural therapy is effective for improving QoL in adults with MDD. Severe depression, females, younger age and comorbid disorders were associated with greater QoL improvements.
The findings suggest iCBT could address depression treatment gaps related to improving QoL. Utilizing iCBT potentially improves the care continuum for individuals with complex disorders.
抑郁症是全球导致残疾的主要原因之一，对生活质量有负面影响。谈话疗法，如认知行为疗法，是治疗抑郁症的有效方法。互联网是精神保健服务的重要工具。互联网提供或在线谈话疗法干预与较低的成本和更高的可及性相关。目前的综述没有涉及互联网提供的认知行为疗法（iCBT）对生活质量（QoL）的有效性。
对于抑郁症状严重程度较大、女性、年轻成年人和患有复杂共病障碍的个体，干预 iCBT 对 QoL 的改善效果更好。对于 iCBT 干预措施，来自医疗保健提供者的支持比自我指导的治疗干预措施效果更好。根据人口的特殊需求调整 iCBT 干预措施是有益的。
有可能解决管理抑郁症患者护理方面的治疗差距。利用 iCBT 促进了在临床环境中提供可及的精神保健服务。医疗保健提供者可以通过考虑与所治疗的临床人群相关的适应措施，对提供 iCBT 采取更全面的方法。
引言：重度抑郁症（MDD）是由影响生活质量（QoL）的社会、心理和生物学因素导致残疾的主要原因。认知行为疗法（CBT）是 MDD 的一种有效心理治疗方法。互联网提供的认知行为疗法（iCBT）与较低的成本和更高的可及性相关。
我们旨在研究 iCBT 对成年人抑郁患者 QoL 的影响。
在 2010 年至 2022 年期间，在 PubMed、Embase 和 PsycINFO 上进行了搜索。纳入标准为实验设计、年龄≥18 岁、抑郁症诊断或有效的自我报告测量、iCBT 干预措施和 QoL 结果。排除标准为没有抑郁分析和智力残疾或精神病的研究。
共纳入 17 篇文章，抑郁严重程度与 QoL 呈负相关。性别、年龄和身体合并症对有效性有积极影响。抑郁严重程度、功能失调态度和消极思维是 QoL 的预测因子和调节因素。临床医生的支持可以影响社会互动和归属感。
互联网提供的认知行为疗法对改善 MDD 成年人的 QoL 是有效的。严重抑郁、女性、年轻和合并症与更大的 QoL 改善相关。
研究结果表明，iCBT 可以解决与改善 QoL 相关的抑郁症治疗差距。利用 iCBT 可能会改善对患有复杂疾病的个体的护理连续性。
