Maj Anna, Michalak Natalia, Graczykowska Agata, Andersson Gerhard
Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.
Faculty of Design, SWPS University of Social Sciences and Humanities, Warsaw, Poland.
Internet Interv. 2023 Jul 23;33:100654. doi: 10.1016/j.invent.2023.100654. eCollection 2023 Sep.
Although numerous studies have examined the effects of internet-delivered cognitive behavioral therapy (iCBT) for depression and anxiety on quality of life, no meta-analysis has yet been conducted to integrate the results of these studies. We conducted systematic searches in PubMed, Cochrane, and PsycInfo, which included terms for treatment type, modality of delivery, condition, and main outcome. We included studies that met the following inclusion criteria: (a) randomized controlled trials, (b) patients allocated to some form of the control condition, (c) patients receiving some type of treatment of anxiety and/or depression involving Internet-delivered Cognitive Behavioral Therapy, (d) use of a validated outcome measure assessing the level of quality of life, (e) conducted with adult participants diagnosed with anxiety disorder and/or unipolar depression, (f) papers written in English. We analyzed 40 randomized controlled trials with a total of 4289 participants that met inclusion criteria. The pooled between-group effect size for the quality of life overall score was small ( = 0.35, 95 % CI: 0.26-0.44, = .0001), favoring iCBT over the control conditions. Regarding the distinct quality of life domains measured by the World Health Organization Quality of Life Assessment, a statistically significant difference between iCBT and control conditions was found only for the physical health domain ( = 0.56, 95 % CI: 0.06-1.07, = .029), in favor of iCBT. In both cases, heterogeneity was moderate. While the effect on the quality of life is small (the overall quality of life score) to moderate (the physical health domain score), we conclude that iCBT for depression and anxiety may be a promising approach for improving the quality of life of patients.
尽管众多研究已考察了互联网认知行为疗法（iCBT）治疗抑郁和焦虑对生活质量的影响，但尚未进行荟萃分析来整合这些研究的结果。我们在PubMed、Cochrane和PsycInfo中进行了系统检索，检索词包括治疗类型、提供方式、疾病状况和主要结局。我们纳入了符合以下纳入标准的研究：（a）随机对照试验；（b）患者被分配至某种形式的对照条件；（c）患者接受某种涉及互联网认知行为疗法的焦虑和/或抑郁治疗；（d）使用经过验证的结局指标评估生活质量水平；（e）研究对象为被诊断患有焦虑症和/或单相抑郁症的成年参与者；（f）论文以英文撰写。我们分析了40项随机对照试验，共有4289名参与者符合纳入标准。生活质量总体得分的组间合并效应量较小（ = 0.35，95% CI：0.26 - 0.44， = 0.0001），表明iCBT优于对照条件。关于世界卫生组织生活质量评估所测量的不同生活质量领域，仅在身体健康领域发现iCBT与对照条件之间存在统计学显著差异（ = 0.56，95% CI：0.06 - 1.07， = 0.029），支持iCBT。在这两种情况下，异质性均为中等。虽然对生活质量的影响较小（总体生活质量得分）至中等（身体健康领域得分），但我们得出结论认为，用于治疗抑郁和焦虑的iCBT可能是改善患者生活质量的一种有前景的方法。
