Cabreira Veronica, Wilkinson Tim, Frostholm Lisbeth, Stone Jon, Carson Alan
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
NPJ Digit Med. 2024 Oct 10;7(1):278. doi: 10.1038/s41746-024-01280-9.
Cognitive symptoms are prevalent across neuropsychiatric disorders, increase distress and impair quality of life. Self-guided digital interventions offer accessibility, scalability, and may overcome the research-to-practice treatment gap. Seventy-six trials with 5214 participants were identified. A random-effects meta-analysis investigated the effects of all digital self-guided interventions, compared to controls, at post-treatment. We found a small-to-moderate positive pooled effect on cognition (k = 71; g = -0.51, 95%CI -0.64 to -0.37; p < 0.00001) and mental health (k = 30; g = -0.41, 95%CI -0.60 to -0.22; p < 0.0001). Positive treatment effects on fatigue (k = 8; g = -0.27, 95%CI -0.53 to -0.02; p = 0.03) and quality of life (k = 22; g = -0.17, 95%CI -0.34 to -0.00; p = 0.04) were only marginally significant. No significant benefit was found for performance on activities of daily living. Results were independent of control groups, treatment duration, risk of bias and delivery format. Self-guided digital transdiagnostic interventions may benefit at least a subset of patients in the short run, yet their impact on non-cognitive outcomes remains uncertain.
认知症状在各种神经精神疾病中普遍存在，会增加痛苦并损害生活质量。自我引导的数字干预具有可及性、可扩展性，并且可能克服研究到实践的治疗差距。共确定了76项试验，涉及5214名参与者。一项随机效应荟萃分析研究了所有数字自我引导干预措施与对照组相比在治疗后的效果。我们发现对认知有小到中等程度的积极合并效应（k = 71；g = -0.51，95%CI -0.64至-0.37；p < 0.00001）以及对心理健康有积极效应（k = 30；g = -0.41，95%CI -0.60至-0.22；p < 0.0001）。对疲劳（k = 8；g = -0.27，95%CI -0.53至-0.02；p = 0.03）和生活质量（k = 22；g = -0.17，95%CI -0.34至-0.00；p = 0.04）的积极治疗效果仅具有边缘显著性。未发现对日常生活活动表现有显著益处。结果不受对照组、治疗持续时间、偏倚风险和交付形式的影响。自我引导的数字跨诊断干预措施可能在短期内至少使一部分患者受益，但其对非认知结果的影响仍不确定。
