Gandy Milena, Heriseanu Andreea I, Balakumar Tanya, Karin Eyal, Walker Jennie, Hathway Taylor, Bisby Madelyne A, Scott Amelia J, Dudeney Joanne, Fisher Alana, Titov Nickolai, Dear Blake F
eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia.
MindSpot Clinic, Macquarie University, Sydney, Australia.
Psychol Med. 2023 Oct;53(14):6817-6827. doi: 10.1017/S0033291723000338. Epub 2023 Mar 1.
Mental health and functional difficulties are highly comorbid across neurological disorders, but supportive care options are limited. This randomised controlled trial assessed the efficacy of a novel transdiagnostic internet-delivered psychological intervention for adults with neurological disorders.
221 participants with a confirmed diagnosis of epilepsy, multiple sclerosis, Parkinson's disease, or an acquired brain injury were allocated to either an immediate treatment group ( = 115) or treatment-as-usual waitlist control ( = 106). The intervention, the Wellbeing Neuro Course, was delivered online via the eCentreClinic website. The Course includes six lessons, based on cognitive behavioural therapy, delivered over 10 weeks with support from a psychologist via email and telephone. Primary outcomes were symptoms of depression (PHQ-9), anxiety (GAD-7) and disability (WHODAS 2.0).
215 participants commenced the trial (treatment = 111; control = 104) and were included in intention-to-treat analysis. At post-treatment, we observed significant between-group differences in depression (PHQ-9; difference = 3.07 [95% CI 2.04-4.11], = 0.62), anxiety (GAD-7; difference = 1.87 [0.92-2.81], = 0.41) and disability (WHODAS 2.0 difference = 3.08 [1.09-5.06], = 0.31), that favoured treatment (all ps < 0.001). Treatment-related effects were maintained at 3-month follow-up. Findings were achieved with minimal clinician time (average of 95.7 min [s.d. = 59.3] per participant), highlighting the public health potential of this approach to care. No adverse treatment events were reported.
Internet-delivered psychological interventions could be a suitable model of accessible supportive care for patients with neurological disorders.
心理健康问题和功能障碍在神经系统疾病中高度共病，但支持性护理选择有限。这项随机对照试验评估了一种新型的、通过互联网提供的针对患有神经系统疾病的成年人的跨诊断心理干预措施的疗效。
221名确诊患有癫痫、多发性硬化症、帕金森病或后天性脑损伤的参与者被分配到即时治疗组（n = 115）或常规治疗等待名单对照组（n = 106）。干预措施“幸福神经课程”通过eCentreClinic网站在线提供。该课程包括六节课，基于认知行为疗法，在10周内授课，并由一名心理学家通过电子邮件和电话提供支持。主要结局指标为抑郁症状（PHQ - 9）、焦虑症状（GAD - 7）和残疾程度（WHODAS 2.0）。
215名参与者开始试验（治疗组n = 111；对照组n = 104）并纳入意向性分析。治疗后，我们观察到两组在抑郁（PHQ - 9；差异 = 3.07 [95%CI 2.04 - 4.11]，p = 0.62）、焦虑（GAD - 7；差异 = 1.87 [0.92 - 2.81]，p = 0.41）和残疾程度（WHODAS 2.0差异 = 3.08 [1.09 - 5.06]，p = 0.31）方面存在显著的组间差异，治疗组更具优势（所有p值均 < 0.001）。与治疗相关的效果在3个月随访时得以维持。这些结果在临床医生投入最少时间（每位参与者平均95.7分钟 [标准差 = 59.3]）的情况下实现，凸显了这种护理方法的公共卫生潜力。未报告不良治疗事件。
通过互联网提供的心理干预可能是为患有神经系统疾病的患者提供可及支持性护理的合适模式。
