Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
J Affect Disord. 2025 Jan 15;369:188-194. doi: 10.1016/j.jad.2024.09.171. Epub 2024 Sep 27.
Depression is a common disorder for which there are several treatments options including different psychological treatments. The aim of this study was to investigate the effects of internet-based interpersonal psychotherapy (IPT) for symptoms of depression in randomized controlled trial.
Following recruitment via advertisement a total of 113 participants with mild to moderate symptoms of depression were included and randomized to either a ten-week internet-based IPT with weekly therapist guidance or a waitlist control condition. The primary outcome was symptoms of depression measured weekly with the Montgomery Åsberg Depression Rating Scale (MADRS-S) and at pre- and post-treatment assessment with the Beck's Depression Inventory (BDI-II). Secondary outcomes were self-rated quality of life and symptoms of generalized anxiety disorder. We also measured therapeutic alliance and treatment credibility. Outcomes were evaluated with a latent growth curve model (for MADRS-S) and robust linear regression models (for the other measures). The trial was conducted during the Covid-19 pandemic in the spring of 2021.
Significant differences favoring the treatment group were found on three of the four outcomes: BDI-II, quality of life ratings, and ratings of generalized anxiety. Between-group effect sizes for these outcomes were moderate (BDI-II, quality of life) or small (generalized anxiety). The latent growth curve model did not indicate a significant difference on the weekly MADRS-S ratings. Exploratory analyses did not show an association between therapeutic alliance, treatment credibility and outcome.
Missing data at post-treatment was high in the treatment group (37 %), though the missingness was not significantly related to observed ratings at pre-treatment or estimated trajectories during the treatment. Few participants completed all modules. The Covid-19 pandemic situation may have affected both effects and dropout rates.
Internet-based IPT can lead to significant improvements, though the reductions in symptoms of depression were not consistent across the two measures used. Completion rates and dropout patterns suggest a need for improved acceptability.
The trial was preregistered at Clinicaltrials.gov (Identifier: NCT04721678). Registered January 2021.https://clinicaltrials.gov/study/NCT04721678.
抑郁症是一种常见的疾病，有多种治疗方法，包括不同的心理治疗。本研究旨在通过随机对照试验研究基于互联网的人际心理治疗（IPT）对抑郁症症状的影响。
通过广告招募，共有 113 名轻度至中度抑郁症患者入组，并随机分为为期十周的基于互联网的 IPT，每周有治疗师指导，或等待对照组。主要结局指标是每周使用蒙哥马利-Åsberg 抑郁评定量表（MADRS-S）和治疗前及治疗后贝克抑郁自评量表（BDI-II）测量的抑郁症状。次要结局指标是自我评估的生活质量和广泛性焦虑症症状。我们还测量了治疗联盟和治疗可信度。采用潜在增长曲线模型（MADRS-S）和稳健线性回归模型（其他指标）评估结果。该试验在 2021 年春季 COVID-19 大流行期间进行。
治疗组在四项结果中的三项上有显著差异：BDI-II、生活质量评分和广泛性焦虑评分。这些结果的组间效应大小为中等（BDI-II，生活质量）或小（广泛性焦虑）。每周 MADRS-S 评分的潜在增长曲线模型未显示出显著差异。探索性分析表明，治疗联盟和治疗可信度与结果之间没有关联。
治疗组在治疗后有较高的缺失数据（37%），但缺失数据与治疗前的观察评分或治疗期间的估计轨迹无显著相关。少数参与者完成了所有模块。COVID-19 大流行情况可能影响了疗效和脱落率。
基于互联网的 IPT 可以显著改善症状，尽管两种使用的测量方法都没有一致地降低抑郁症的症状。完成率和脱落模式表明需要提高可接受性。
该试验在 Clinicaltrials.gov 进行了预先注册（标识符：NCT04721678）。2021 年 1 月注册。https://clinicaltrials.gov/study/NCT04721678。
