Woebot Health, 535 Mission Street, 14th Floor, San Francisco, CA, 94105, USA.
RR&D Center for Neurorestoration and Neurotechnology, VA Providence Healthcare System, Providence, RI, USA.
BMC Psychiatry. 2024 Jan 30;24(1):79. doi: 10.1186/s12888-024-05532-6.
Digital mental health interventions (DMHIs) may reduce treatment access issues for those experiencing depressive and/or anxiety symptoms. DMHIs that incorporate relational agents may offer unique ways to engage and respond to users and to potentially help reduce provider burden. This study tested Woebot for Mood & Anxiety (W-MA-02), a DMHI that employs Woebot, a relational agent that incorporates elements of several evidence-based psychotherapies, among those with baseline clinical levels of depressive or anxiety symptoms. Changes in self-reported depressive and anxiety symptoms over 8 weeks were measured, along with the association between each of these outcomes and demographic and clinical characteristics.
This exploratory, single-arm, 8-week study of 256 adults yielded non-mutually exclusive subsamples with either clinical levels of depressive or anxiety symptoms at baseline. Week 8 Patient Health Questionnaire-8 (PHQ-8) changes were measured in the depressive subsample (PHQ-8 ≥ 10). Week 8 Generalized Anxiety Disorder-7 (GAD-7) changes were measured in the anxiety subsample (GAD-7 ≥ 10). Demographic and clinical characteristics were examined in association with symptom changes via bivariate and multiple regression models adjusted for W-MA-02 utilization. Characteristics included age, sex at birth, race/ethnicity, marital status, education, sexual orientation, employment status, health insurance, baseline levels of depressive and anxiety symptoms, and concurrent psychotherapeutic or psychotropic medication treatments during the study.
Both the depressive and anxiety subsamples were predominantly female, educated, non-Hispanic white, and averaged 38 and 37 years of age, respectively. The depressive subsample had significant reductions in depressive symptoms at Week 8 (mean change =-7.28, SD = 5.91, Cohen's d = -1.23, p < 0.01); the anxiety subsample had significant reductions in anxiety symptoms at Week 8 (mean change = -7.45, SD = 5.99, Cohen's d = -1.24, p < 0.01). No significant associations were found between sex at birth, age, employment status, educational background and Week 8 symptom changes. Significant associations between depressive and anxiety symptom outcomes and sexual orientation, marital status, concurrent mental health treatment, and baseline symptom severity were found.
The present study suggests early promise for W-MA-02 as an intervention for depression and/or anxiety symptoms. Although exploratory in nature, this study revealed potential user characteristics associated with outcomes that can be investigated in future studies.
This study was retrospectively registered on ClinicalTrials.gov (#NCT05672745) on January 5th, 2023.
数字心理健康干预（DMHI）可能会减少有抑郁和/或焦虑症状的人的治疗机会问题。整合关系型代理的 DMHI 可能会提供独特的方式来吸引和回应用户，并有可能帮助减轻提供者的负担。本研究测试了 Woebot for Mood & Anxiety（W-MA-02），这是一种 DMHI，它使用 Woebot，这是一种整合了几种循证心理疗法元素的关系型代理，用于有基线临床水平的抑郁或焦虑症状的患者。通过 8 周的时间测量自我报告的抑郁和焦虑症状的变化，并研究这些结果与人口统计学和临床特征之间的关系。
本研究为 256 名成年人进行的探索性、单臂、8 周研究，基线时有临床水平的抑郁或焦虑症状的患者分别组成非互斥亚组。在抑郁亚组中测量第 8 周的患者健康问卷-8（PHQ-8）变化（PHQ-8≥10）。在焦虑亚组中测量第 8 周的广泛性焦虑症-7（GAD-7）变化（GAD-7≥10）。通过双变量和多元回归模型，调整 W-MA-02 的使用，检查人口统计学和临床特征与症状变化的关系。特征包括年龄、出生时的性别、种族/民族、婚姻状况、教育程度、性取向、就业状况、健康保险、基线抑郁和焦虑症状水平以及研究期间同时进行的心理治疗或精神药物治疗。
抑郁和焦虑亚组均以女性、受过教育、非西班牙裔白人为主，平均年龄分别为 38 岁和 37 岁。抑郁亚组在第 8 周时抑郁症状显著减轻（平均变化=-7.28，SD=5.91，Cohen's d=-1.23，p<0.01）；焦虑亚组在第 8 周时焦虑症状显著减轻（平均变化=-7.45，SD=5.99，Cohen's d=-1.24，p<0.01）。出生时的性别、年龄、就业状况、教育背景与第 8 周的症状变化之间无显著相关性。在抑郁和焦虑症状的结果与性取向、婚姻状况、同时进行的心理健康治疗和基线症状严重程度之间发现了显著的相关性。
本研究表明 W-MA-02 作为一种抑郁和/或焦虑症状的干预措施具有早期的应用前景。尽管研究性质为探索性，但本研究揭示了与结果相关的潜在用户特征，可以在未来的研究中进行调查。
本研究于 2023 年 1 月 5 日在 ClinicalTrials.gov 上进行了回顾性注册（#NCT05672745）。
