Olivar Natividad, Carbonetti Fernando Luis, Brusco Luis Ignacio, Priebe Stefan
Center of Behavioral Neurology and Neuropsychiatry, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Centre for Psychosocial Medicine, University of Hamburg, Hamburg, Germany.
PLoS One. 2025 May 19;20(5):e0321744. doi: 10.1371/journal.pone.0321744. eCollection 2025.
Low-cost interventions in routine care are needed to reduce the burden of anxiety disorders. DIALOG+ is an evidence-based intervention specifically designed to make routine patient-clinician meetings in mental health care therapeutically effective. It has been shown to be beneficial in a range of studies, but so far not been tested in patients with a primary diagnosis of anxiety disorders.
We conducted a non-controlled pilot trial in an out-patient service in Buenos Aires, Argentina. DIALOG+ was applied five times over a six-month period. Because of the pandemic all sessions had to be delivered remotely which had not been originally planned. At baseline and after the intervention, we assessed as outcome criteria subjective quality of life on the Manchester Short Assessment of Quality of Life, general symptoms on the Brief Psychiatric Rating Scale and the objective social situation on the Social Outcomes Index. Patient experiences were explored in semi-structured interviews.
Forty patients completed the study. All outcome criteria, quality of life (4.1±0.5 to 5.0±0.5; p<0.001), general symptoms (33.0±9.3 to 25.9±7.6; p<0.001) and the objective social situation (5.2±0.9 to 5.6±0.5; p=0.008) showed significant improvements. Patient reported largely positive experiences despite frequent technical problems with the online arrangements.
The findings suggest that DIALOG+ is feasible and beneficial for patients with anxiety disorders in routine care and that a remote delivery is a feasible realistic option for administering it. Future research should assess implementation methods and effectiveness in larger controlled trials and identify the effective mechanisms in DIALOG+.
The trial was pre-registered (https://www.isrctn.com/ISRCTN38851969) on 16/12/2019.
需要在常规护理中采取低成本干预措施以减轻焦虑症的负担。DIALOG+是一种基于证据的干预措施，专门设计用于使精神卫生保健中的常规患者-临床医生会面具有治疗效果。一系列研究表明它是有益的，但迄今为止尚未在原发性焦虑症患者中进行测试。
我们在阿根廷布宜诺斯艾利斯的一家门诊服务机构进行了一项非对照试点试验。在六个月的时间内应用了五次DIALOG+。由于疫情，所有疗程都必须远程进行，这原本并未在计划之中。在基线和干预后，我们评估了作为结果标准的曼彻斯特生活质量简短评估中的主观生活质量、简明精神病评定量表上的一般症状以及社会结果指数上的客观社会状况。通过半结构化访谈探索了患者的体验。
40名患者完成了研究。所有结果标准，生活质量（从4.1±0.5至5.0±0.5；p<0.001）、一般症状（从33.0±9.3至25.9±7.6；p<0.001）和客观社会状况（从5.2±0.9至5.6±0.5；p=0.008）均显示出显著改善。尽管在线安排经常出现技术问题，但患者报告的体验大多是积极的。
研究结果表明，DIALOG+在常规护理中对焦虑症患者是可行且有益的，并且远程实施是一种可行的现实选择。未来的研究应在更大规模的对照试验中评估实施方法和有效性，并确定DIALOG+中的有效机制。
该试验于2019年12月16日进行了预注册（https://www.isrctn.com/ISRCTN38851969）。
