Oliveira Machado Cecagno Priscila, Donati Polesello Natália, Duque-Cartagena Tatiana, Machado Luz Pedro, Mundstock Eduardo, Bernardina Dalla Marcello Dala, Kazutoshi Sato Douglas, Mattiello Rita
Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
School of Medicine, Graduate Program in Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Telemed J E Health. 2025 Feb;31(2):141-150. doi: 10.1089/tmj.2024.0297. Epub 2024 Sep 20.
Anxiety and depression are common mental disorders that are highly prevalent worldwide. Clinical trials have found that telehealth interventions result in increased accessibility and improved mental treatment effectiveness. However, a few comprehensive syntheses of evidence from randomized clinical trials that have been conducted to evaluate remote psychological vs face-to-face interventions for anxiety and depression are not conclusive. The objective of this work was to evaluate the efficacy of remote psychological interventions for patients with anxiety and depression symptoms. Randomized clinical trials with the following criteria were included: participants aged ≥5 years, of both sexes, and who underwent psychological therapy to treat anxiety and or depression symptoms. They were randomized to receive the same psychological treatment remotely or face-to-face. Review studies, animal studies, pilot studies, and studies with patients diagnosed with chronic diseases were excluded. Searches were performed on March 2024 in the following databases: MEDLINE, EMBASE, LILACS, CENTRAL, CINAHL, Web of Science, SciELO, APA PsycINFO, and Scopus. The meta-analysis was conducted using the random-effects model, and the standardized mean difference with the 95% confidence interval (CI) was used to estimate the effect. Six studies were included in this systematic review. The meta-analysis showed no statistically significant difference when comparing remote or face-to-face treatment for depression (SMD of -0.10 [95% CI: -0.57 to 0.37; : 77%]) and anxiety (SMD of -0.06 [95% CI: -0.34 to 0.21; : 0%]) symptoms. Our meta-analysis indicates that remote psychotherapy demonstrates comparable efficacy to face-to-face care in mitigating symptoms of depression and anxiety. It allows patients to select the best modality for their daily routines, promoting greater engagement and adherence to treatment.
焦虑和抑郁是常见的精神障碍，在全球范围内高度流行。临床试验发现，远程医疗干预可提高可及性并改善心理治疗效果。然而，一些为评估针对焦虑和抑郁的远程心理干预与面对面干预而进行的随机临床试验的综合证据并不确凿。这项工作的目的是评估针对有焦虑和抑郁症状患者的远程心理干预的疗效。纳入了符合以下标准的随机临床试验：年龄≥5岁、男女均可且接受心理治疗以治疗焦虑和/或抑郁症状的参与者。他们被随机分配接受相同心理治疗的远程或面对面方式。排除综述研究、动物研究、试点研究以及针对诊断患有慢性病患者的研究。于2024年3月在以下数据库进行检索：MEDLINE、EMBASE、LILACS、CENTRAL、CINAHL、科学引文索引、SciELO、美国心理学会心理学文摘数据库和Scopus。采用随机效应模型进行荟萃分析，并使用95%置信区间（CI）的标准化平均差来估计效应。本系统评价纳入了六项研究。荟萃分析显示，在比较远程或面对面治疗抑郁（标准化平均差为-0.10 [95% CI：-0.57至0.37；I²：77%]）和焦虑（标准化平均差为-0.06 [95% CI：-0.34至0.21；I²：0%]）症状时，无统计学显著差异。我们的荟萃分析表明，远程心理治疗在减轻抑郁和焦虑症状方面显示出与面对面护理相当的疗效。它使患者能够为其日常生活选择最佳方式，促进更高的参与度和治疗依从性。
