Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
JMIR Mhealth Uhealth. 2023 Dec 13;11:e50636. doi: 10.2196/50636.
To address the growing prevalence of youth mental health problems, early intervention is crucial to minimize individual, societal, and economic impacts. Indicative prevention aims to target emerging mental health complaints before the onset of a full-blown disorder. When intervening at this early stage, individuals are more responsive to treatment, resulting in cost-effective outcomes. The Moderated Online Social Therapy platform, which was successfully implemented and proven effective in Australia, is a digital, peer- and clinically moderated treatment platform designed for young people. The Netherlands was the first country outside Australia to implement this platform, under the name Engage Young People Early (ENYOY). It has the potential to reduce the likelihood of young people developing serious mental health disorders.
This study aims to investigate the effects on young people using the ENYOY-platform in relation to psychological distress, psychosocial functioning, and positive health parameters.
Dutch-speaking young people with emerging mental health complaints (N=131) participated in the ENYOY-platform for 6 months in a repeated measures within-subjects study. Psychological distress, psychosocial functioning, and positive health parameters were assessed at baseline and 3, 6, and 12 months. Repeated measures ANOVA was conducted and adjusted for age, sex, therapy, and community activity. The Reliable Change Index and Clinically Significant Index were computed to compare the baseline with the 6- and 12-month measurements. The missing data rate was 22.54% and the dropout rate 62.6% (82/131).
The primary analysis (77/131, 58.8%) showed that psychological distress decreased and psychosocial functioning improved over time with large effect sizes (P<.001 in both cases; η=0.239 and 0.318, respectively) independent of age (P=.76 for psychological distress and P=.48 for psychosocial functioning), sex (P=.24 and P=.88, respectively), therapy activity (P=.49 and P=.80, respectively), or community activity (P=.59 and P=.48, respectively). Similarly, secondary analyses (51/131, 38.9%) showed significant effects of time on the quality of life, well-being, and meaningfulness positive health parameters (P<.05; η=0.062, 0.140, and 0.121, respectively). Improvements in all outcome measures were found between baseline and 3 and 6 months (P≤.001-.01; d=0.23-0.62) and sustained at follow-up (P=.18-.97; d=0.01-0.16). The Reliable Change Index indicated psychological distress improvements in 38% (39/102) of cases, no change in 54.9% (56/102) of cases, and worsening in 5.9% (6/102) of cases. Regarding psychosocial functioning, the percentages were 50% (51/102), 43.1% (44/102), and 6.9% (7/102), respectively. The Clinically Significant Index demonstrated clinically significant changes in 75.5% (77/102) of cases for distress and 89.2% (91/102) for functioning.
This trial demonstrated that the ENYOY-platform holds promise as a transdiagnostic intervention for addressing emerging mental health complaints among young people in the Netherlands and laid the groundwork for further clinical research. It would be of great relevance to expand the population on and service delivery of the platform.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12888-021-03315-x.
为了解决青少年心理健康问题日益严重的问题,早期干预对于最小化个人、社会和经济影响至关重要。指示性预防旨在在全面障碍发作之前针对新兴的心理健康问题进行干预。在这个早期阶段进行干预时,个体对治疗的反应性更高,从而产生具有成本效益的结果。Moderated Online Social Therapy 平台在澳大利亚成功实施并被证明有效,是一个针对年轻人的数字、同辈和临床调节治疗平台。荷兰是澳大利亚以外第一个实施该平台的国家,名为 Engage Young People Early(ENYOY)。它有可能降低年轻人出现严重心理健康障碍的可能性。
本研究旨在调查荷兰青少年在使用 ENYOY 平台方面的效果,包括心理困扰、心理社会功能和积极健康参数。
本研究招募了 131 名有新兴心理健康问题的荷兰青少年,他们在一项重复测量的自身对照研究中使用 ENYOY 平台进行了 6 个月的治疗。在基线和 3、6 和 12 个月时评估心理困扰、心理社会功能和积极健康参数。进行了重复测量方差分析,并根据年龄、性别、治疗和社区活动进行了调整。计算了可靠变化指数和临床显著指数,以比较基线和 6 个月和 12 个月的测量结果。缺失数据率为 22.54%,辍学率为 62.6%(82/131)。
主要分析(77/131,58.8%)显示,心理困扰随时间减少,心理社会功能随时间改善,具有较大的效应量(P<.001 在两种情况下;η=0.239 和 0.318,分别),独立于年龄(P=.76 对于心理困扰,P=.48 对于心理社会功能)、性别(P=.24 和 P=.88,分别)、治疗活动(P=.49 和 P=.80,分别)或社区活动(P=.59 和 P=.48,分别)。同样,二次分析(51/131,38.9%)显示,时间对生活质量、幸福感和有意义的积极健康参数有显著影响(P<.05;η=0.062、0.140 和 0.121,分别)。在所有结局测量中,基线与 3 个月和 6 个月时均发现改善(P≤.001-.01;d=0.23-0.62),随访时仍持续(P=.18-.97;d=0.01-0.16)。可靠变化指数表明,38%(39/102)的病例心理困扰有所改善,54.9%(56/102)的病例无变化,5.9%(6/102)的病例恶化。关于心理社会功能,百分比分别为 50%(51/102)、43.1%(44/102)和 6.9%(7/102)。临床显著指数表明,75.5%(77/102)的病例有显著的困扰变化,89.2%(91/102)的病例有显著的功能变化。
本试验表明,ENYOY 平台作为一种针对荷兰青少年新兴心理健康问题的跨诊断干预方法具有前景,并为进一步的临床研究奠定了基础。扩大该平台的人群和服务提供将具有重要意义。
国际注册报告标识符(IRRID):RR2-10.1186/s12888-021-03315-x。