Sapkota Ram P, Valli Emma, Dear Blake F, Titov Nickolai, Hadjistavropoulos Heather D
Online Therapy Unit, University of Regina, Regina, SK, Canada.
eCentreClinic, Macquarie University, Sydney, NSW, Australia.
Front Psychiatry. 2024 Mar 4;15:1270543. doi: 10.3389/fpsyt.2024.1270543. eCollection 2024.
Depression and anxiety are the most common mental health disorders worldwide. Internet-Delivered Cognitive Behaviour Therapy (ICBT) can reduce barriers to care to broad cross sections of the population. However, People of Diverse Ethnocultural Backgrounds (PDEGs) other than White/Caucasian underutilize mental health services and are under represented in clinical trials of psychological interventions.
To address this research gap we adapted an evidence-based ICBT program for PDEGs. The current pilot study explores the engagement, satisfaction, and effectiveness in the adapted ICBT program by PDEGs (N=41) when benchmarked against a sample of PDEGs (N=134) who previously completed a non-adapted version of the ICBT program.
An intent-to-treat analyses showed that the adapted ICBT program is effective in reducing anxiety and depression symptoms among PDEGs. Large within-group pre-to post-treatment Cohen's effect sizes of = 1.23, 95% CI [0.68, 1.77] and = 1.24, 95% CI [0.69, 1.79] were found for depression and anxiety, respectively. Further, 81.8% of the PDEGs who received the adapted ICBT reported overall satisfaction, 90.9% reported increased confidence in managing symptoms, and 70.7% completed majority of the psychoeducational lessons in the ICBT program.
No statistically significant differences in the clinical outcomes, engagement, and satisfaction were found between the pilot study and benchmark sample. Future directions for ICBT research with PDEGs are described.
https://beta.clinicaltrials.gov/study/NCT05523492, identifier NCT05523492.
抑郁症和焦虑症是全球最常见的心理健康障碍。互联网认知行为疗法(ICBT)可以减少广泛人群获得治疗的障碍。然而,除白人/高加索人之外的不同种族文化背景的人(PDEGs)未充分利用心理健康服务,并且在心理干预的临床试验中代表性不足。
为了填补这一研究空白,我们为PDEGs改编了一个基于证据的ICBT项目。当前的试点研究通过将PDEGs(N = 41)与之前完成非改编版ICBT项目的PDEGs样本(N = 134)进行对比,探索改编后的ICBT项目中PDEGs的参与度、满意度和有效性。
意向性分析表明,改编后的ICBT项目在减轻PDEGs的焦虑和抑郁症状方面是有效的。抑郁和焦虑的组内治疗前至治疗后的大效应量分别为Cohen's d = 1.23,95% CI [0.68, 1.77]和Cohen's d = 1.24,95% CI [0.69, 1.79]。此外,接受改编后ICBT的PDEGs中有81.8%报告总体满意,90.9%报告在管理症状方面信心增强,70.7%完成了ICBT项目中的大部分心理教育课程。
在试点研究和基准样本之间,在临床结果、参与度和满意度方面未发现统计学上的显著差异。描述了未来针对PDEGs进行ICBT研究的方向。
https://beta.clinicaltrials.gov/study/NCT05523492,标识符NCT05523492。