在线认知行为疗法与面对面认知行为疗法对重度抑郁症患者疗效的比较：一项非随机对照试验
Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial.
作者信息
Alavi Nazanin, Moghimi Elnaz, Stephenson Callum, Gutierrez Gilmar, Jagayat Jasleen, Kumar Anchan, Shao Yijia, Miller Shadé, Yee Caitlin S, Stefatos Anthi, Gholamzadehmir Maedeh, Abbaspour Zara, Shirazi Amirhossein, Gizzarelli Tessa, Khan Ferwa, Patel Charmy, Patel Archana, Yang Megan, Omrani Mohsen
机构信息
Department of Psychiatry, Queen's University, Kingston, ON, Canada.
Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
出版信息
Front Psychiatry. 2023 Apr 28;14:1113956. doi: 10.3389/fpsyt.2023.1113956. eCollection 2023.
OBJECTIVE
The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD.
METHODS
Participants ( = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants ( = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group ( = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires.
RESULTS
Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group.
CONCLUSION
The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.
目的
在新冠疫情期间，重度抑郁症（MDD）的患病率上升，导致在线心理健康护理服务大幅增长。与面对面治疗相比，在线认知行为疗法（e-CBT）是一种时间灵活且经济高效的改善MDD症状的方法。然而，其疗效与面对面认知行为疗法（CBT）相比如何，尚未得到探索。因此，本研究比较了由治疗师支持的电子交付e-CBT项目与面对面治疗对诊断为MDD的个体的疗效。
方法
108名被诊断为MDD的参与者选择了为期12周的面对面CBT或由治疗师支持的异步e-CBT项目。e-CBT组的55名参与者完成了通过安全的基于云的在线平台（在线心理治疗工具；OPTT）提供的每周交互式在线模块。这些模块之后是家庭作业，参与者会收到来自训练有素的治疗师的个性化反馈。面对面CBT组的53名参与者在每周一小时的会议期间与他们的治疗师讨论课程和家庭作业。使用经过临床验证的症状学和生活质量问卷评估项目疗效。
结果
从基线到治疗后，两种治疗方法在抑郁症状和生活质量方面均有显著改善。选择面对面治疗的参与者的基线症状评分显著高于e-CBT组。然而，从基线到治疗后，两种治疗方法在抑郁症状和生活质量方面均有相当显著的改善。e-CBT似乎能使参与者的依从性更高，因为e-CBT组的退出者平均完成的课程比面对面CBT组的更多。
结论
研究结果支持在治疗师指导下的e-CBT作为治疗MDD的合适选择。未来的研究应调查治疗可及性与e-CBT组和面对面组的项目完成率之间的关系。
临床试验注册
ClinicalTrials.Gov协议注册和结果系统（NCT04478058）；clinicaltrials.gov/ct2/show/NCT04478058 。
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