Lee Jennifer L, Chen Shih-Yin, Wickham Robert E, Wang Pam, Wu Monica S, Varra Alethea A, Chen Connie E, Lungu Anita
Lyra Health, 270 East Lane Burlingame, CA 94010, United States of America.
Emory University, 1405 Clifton Rd. NE, Atlanta, GA 30307, United States of America.
Internet Interv. 2024 Dec 28;39:100798. doi: 10.1016/j.invent.2024.100798. eCollection 2025 Mar.
Scalable evidence-based treatments for anxiety and depression, such as blended care therapy (BCT) that integrate digital tools are effective, but reporting on long-term outcomes is limited.
This pragmatic observational study examined the symptom stability and trajectories of individuals in the year following engagement in a BCT program. Participants included adults with clinical anxiety and/or depression measured by the Generalized Anxiety Disorder-7 (GAD-7) or Patient Health Questionnaire-9 (PHQ-9). Assessments were sent during the initial episode of care and in the year following.
Participants included 27,835 adults (depression: 17,686 and anxiety: 24,853). Of these, 11,465 (41 % of those who received initial care; depression: 7223; anxiety: 10,218) completed at least one follow-up assessment (FUA). Average age was 34 years, 68-69 % were female, and 48-49 % were White across subsamples. Among FUA respondents, rates of reliable improvement or recovery on the PHQ-9 or GAD-7 for those who did not receive additional therapy were above 81 % across follow-up periods. Growth curve analysis for those who did not return for additional therapy revealed that both depression and anxiety groups demonstrated a statistically significant yet small linear effect of time in the year following treatment, with a 1.6-2.1 point increase in scores over the 12-month period.
Among clients who completed FUAs and received no additional therapy, reliable improvement and recovery rates were high. Growth curve analysis demonstrated a small increase in symptoms over the 12-month interval, providing pragmatic evidence of long-term stability of treatment gains from BCT for anxiety and depression in a real-world setting.
可扩展的基于证据的焦虑和抑郁治疗方法，如整合数字工具的混合式护理疗法（BCT）是有效的，但关于长期结果的报告有限。
这项务实的观察性研究考察了参与BCT项目一年后个体的症状稳定性和轨迹。参与者包括通过广泛性焦虑障碍-7（GAD-7）或患者健康问卷-9（PHQ-9）测量患有临床焦虑和/或抑郁的成年人。在初次护理期间及之后的一年中进行评估。
参与者包括27,835名成年人（抑郁症患者：17,686名；焦虑症患者：24,853名）。其中，11,465名（接受初次护理者的41%；抑郁症患者：7223名；焦虑症患者：10,218名）完成了至少一次随访评估（FUA）。各子样本的平均年龄为34岁，68%-69%为女性，48%-49%为白人。在FUA受访者中，未接受额外治疗者在各随访期内PHQ-9或GAD-7的可靠改善或康复率均高于81%。对未返回接受额外治疗者的生长曲线分析显示，抑郁症和焦虑症组在治疗后的一年中均表现出统计学上显著但较小的时间线性效应，12个月期间得分增加1.6-2.1分。
在完成FUA且未接受额外治疗的客户中，可靠改善和康复率很高。生长曲线分析表明，在12个月的间隔期内症状略有增加，这为BCT在现实环境中治疗焦虑和抑郁所取得的长期疗效稳定性提供了务实证据。
