Schefft Cora, Krämer Rico, Haaf Raoul, Jedeck David, Schumacher Anna, Köhler Stephan
Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
Department of Psychology, Humboldt University of Berlin, Berlin, Germany.
Qual Life Res. 2024 May;33(5):1275-1286. doi: 10.1007/s11136-024-03606-2. Epub 2024 Feb 25.
PURPOSE: Depressive disorders cause a major burden of disease worldwide and often lead to a loss of social functioning. Patients suffering from depressive disorders report a lower quality of life (QOL) than people without a history of mental health issues. Internet-based interventions (IBIs) based on cognitive behavioral therapy (CBT) are effective in reducing symptom severity but data on their impact on quality of life in clinically depressed patients so far is scarce. METHODS: Selfapy is a CBT-based IBI for depressive disorders. 401 participants (332 female, mean age 37 (SD = 11) with a diagnosis of major depressive disorder (MDD) or dysthymia were enrolled in a randomized, parallel, three-arm trial comparing a therapist-guided Selfapy intervention with an unguided Selfapy intervention and a waiting list control. QOL was measured using the WHOQOL-BREF at baseline, post-treatment (12 weeks) and at 24-week follow-up. The effects of the interventions on QOL were calculated using linear mixed effects models. RESULTS: At post-treatment (12 weeks) the guided and unguided intervention groups reported an increase in QOL on physical and psychological health domains compared to controls (significant group*time interaction). The gain in QOL was maintained over the follow-up period only for psychological health. QOL decreased in the social relationships and environment domains over the course of treatment and during the follow-up treatment for all participants. There were no differences between the guided and the unguided intervention. CONCLUSION: Selfapy proved to positively affect psychological and physical QOL in a sample of participants suffering from depressive disorders and can therefore be considered an effective and highly scalable therapeutic tool. The pattern of results might partly be attributable to effects of the COVID-19 pandemic and public health measures that coincided with the trial. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00017191. Registered June 14th, 2019, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017191 .
目的：抑郁症在全球造成了重大疾病负担，常常导致社会功能丧失。与没有心理健康问题病史的人相比，抑郁症患者报告的生活质量（QOL）较低。基于认知行为疗法（CBT）的互联网干预措施（IBIs）在减轻症状严重程度方面有效，但目前关于其对临床抑郁症患者生活质量影响的数据很少。 方法：Selfapy是一种基于CBT的针对抑郁症的IBI。401名参与者（332名女性，平均年龄37岁（标准差=11），被诊断为重度抑郁症（MDD）或心境恶劣）参加了一项随机、平行、三臂试验，比较了治疗师指导的Selfapy干预、无指导的Selfapy干预和等待名单对照。在基线、治疗后（12周）和24周随访时使用世界卫生组织生活质量简表（WHOQOL-BREF）测量生活质量。使用线性混合效应模型计算干预对生活质量的影响。 结果：在治疗后（12周），与对照组相比，有指导和无指导的干预组在生理和心理健康领域的生活质量均有所提高（显著的组*时间交互作用）。仅在心理健康方面，生活质量的改善在随访期得以维持。在整个治疗过程和随访期间，所有参与者在社会关系和环境领域的生活质量均下降。有指导和无指导的干预之间没有差异。 结论：Selfapy在抑郁症患者样本中被证明对心理和生理生活质量有积极影响，因此可被视为一种有效且高度可扩展的治疗工具。结果模式可能部分归因于与试验同时发生的2019冠状病毒病大流行和公共卫生措施的影响。 试验注册：德国临床试验注册中心（DRKS）：DRKS00017191。2019年6月14日注册，https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017191 。
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