Baumeister Anna, Schuurmans Lea, Moritz Steffen
University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Germany.
Internet Interv. 2025 Aug 8;41:100867. doi: 10.1016/j.invent.2025.100867. eCollection 2025 Sep.
Anxiety disorders are the most common psychiatric condition, yet few patients receive adequate treatment, primarily due to high barriers to treatment (e.g., long waiting times, fear of stigmatization). Internet-based cognitive behavioral therapy (iCBT) programs have emerged as a promising approach to addressing this treatment gap, demonstrating effectiveness across various anxiety disorders. However, only a few studies have specifically addressed unguided iCBT. This trial investigated a six-week transdiagnostic unguided iCBT intervention designed to reduce anxiety and related symptoms.
Randomized to an intervention group and a waitlist control group with care as usual, 318 participants were included in the analyses, which used ANCOVAs to assess changes in symptom severity of anxiety (primary) and related secondary outcomes (stress, depression and anxiety, quality of life, self-esteem).
Significant post-intervention reductions in anxiety, stress, and depression were found in the intervention group compared to controls at small to medium effect sizes (|Hedges's | = 0.27-0.35). Concurrent ongoing psychotherapy negatively modified the treatment effect.
The iCBT program proved effective overall in reducing anxiety and anxiety-related symptoms compared to care as usual. However, the program did not appear to have an add-on effect for individuals who were simultaneously receiving conventional psychotherapy. Further research is needed to investigate the effects in this subgroup in more detail.
焦虑症是最常见的精神疾病，但很少有患者得到充分治疗，主要原因是治疗障碍重重（如等待时间长、害怕被污名化）。基于互联网的认知行为疗法（iCBT）项目已成为解决这一治疗差距的一种有前景的方法，在各种焦虑症中均显示出有效性。然而，只有少数研究专门针对无指导的iCBT。本试验调查了一项为期六周的跨诊断无指导iCBT干预措施，旨在减轻焦虑及相关症状。
将318名参与者随机分为干预组和等待名单对照组（照常护理），分析采用协方差分析来评估焦虑症状严重程度（主要指标）以及相关次要结果（压力、抑郁和焦虑、生活质量、自尊）的变化。
与对照组相比，干预组在干预后焦虑、压力和抑郁有显著降低，效应量为小到中等（|Hedges's| = 0.27 - 0.35）。同时进行的心理治疗对治疗效果有负面影响。
与照常护理相比，iCBT项目总体上被证明在减轻焦虑及焦虑相关症状方面有效。然而，该项目对同时接受传统心理治疗的个体似乎没有附加效果。需要进一步研究更详细地调查该亚组中的效果。
