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比较电子传递认知行为疗法 (e-CBT) 与每周在线心理健康检查治疗广泛性焦虑症的疗效:一项随机对照试验

Comparing the Efficacy of Electronically Delivered Cognitive Behavioral Therapy (e-CBT) to Weekly Online Mental Health Check-Ins for Generalized Anxiety Disorder-A Randomized Controlled Trial: Comparaison de l'efficacité de la thérapie cognitivo-comportementale délivrée par voie électronique (e-TCC) aux contrôles hebdomadaires en ligne de santé mentale pour le trouble d'anxiété généralisée - un essai randomisé contrôlé.

机构信息

Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.

Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.

出版信息

Can J Psychiatry. 2024 Sep;69(9):695-707. doi: 10.1177/07067437241261933. Epub 2024 Jul 21.

Abstract

BACKGROUND

Generalized anxiety disorder (GAD) is a prevalent anxiety disorder characterized by uncontrollable worry, trouble sleeping, muscle tension, and irritability. Cognitive behavioural therapy (CBT) is one of the first-line treatments that has demonstrated high efficacy in reducing symptoms of anxiety. Electronically delivered CBT (e-CBT) has been a promising adaptation of in-person treatment, showing comparable efficacy with increased accessibility and scalability. Finding further scalable interventions that can offer benefits to patients requiring less intensive interventions can allow for better resource allocation. Some studies have indicated that weekly check-ins can also lead to improvements in GAD symptoms. However, there is a lack of research exploring the potential benefits of online check-ins for patients with GAD.

OBJECTIVE

This study aims to investigate the effects of weekly online asynchronous check-ins on patients diagnosed with GAD and compare it with a group receiving e-CBT.

METHODS

Participants ( e-CBT = 45; check-in = 51) with GAD were randomized into either an e-CBT or a mental health check-in program for 12 weeks. Participants in the e-CBT program completed pre-designed modules and homework assignments through a secure online delivery platform where they received personalized feedback from a trained care provider. Participants in the mental health check-in condition had weekly asynchronous messaging communication with a care provider where they were asked structured questions with a different weekly theme to encourage conversation.

RESULTS

Both treatments demonstrated statistically significant reductions in GAD-7-item questionnaire (GAD-7) scores over time, but when comparing the groups there was no significant difference between the treatments. The number of participants who dropped out and baseline scores on all questionnaires were comparable for both groups.

CONCLUSIONS

The findings support the effectiveness of e-CBT and mental health check-ins for the treatment of GAD.

PLAIN LANGUAGE SUMMARY TITLE

Comparing the Effectiveness of Electronically Delivered Therapy (e-CBT) to Weekly Online Mental Health Check-ins for Generalized Anxiety Disorder-A Randomized Controlled Trial.

摘要

背景

广泛性焦虑障碍(GAD)是一种普遍存在的焦虑障碍,其特征是无法控制的担忧、睡眠问题、肌肉紧张和易怒。认知行为疗法(CBT)是一线治疗方法之一,已证明其在减轻焦虑症状方面具有很高的疗效。电子传递的 CBT(e-CBT)是一种很有前途的治疗方法,可以提高可及性和可扩展性。寻找更具可扩展性的干预措施,可以为需要较少强化干预的患者提供益处,可以更好地分配资源。一些研究表明,每周检查也可以改善 GAD 症状。然而,目前缺乏研究探索在线检查对 GAD 患者的潜在益处。

目的

本研究旨在探讨每周在线异步检查对 GAD 患者的影响,并将其与接受 e-CBT 的患者进行比较。

方法

将 GAD 患者(e-CBT 组=45;检查组=51)随机分为 e-CBT 或心理健康检查方案 12 周。接受 e-CBT 方案的患者通过安全的在线交付平台完成预先设计的模块和家庭作业,在该平台上,他们会收到经过培训的护理提供者的个性化反馈。在心理健康检查条件下,患者每周与护理提供者进行异步消息传递,护理提供者会提出结构化问题,并针对不同的每周主题进行鼓励性对话。

结果

两种治疗方法均显示 GAD-7 项问卷(GAD-7)评分随时间显著降低,但在比较两组时,治疗方法之间没有显著差异。两组的退出人数和所有问卷的基线评分都相当。

结论

这些发现支持了 e-CBT 和心理健康检查在治疗 GAD 方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b1/11351059/17a6c95aa6b1/10.1177_07067437241261933-fig1.jpg

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