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一项在伊朗进行的针对患有焦虑症和抑郁症青少年的面对面与基于互联网的统一跨诊断治疗比较的试点随机试验。

A pilot randomized trial comparing face-to-face and internet-based unified transdiagnostic treatment for adolescents with anxiety and depressive disorders in Iran.

作者信息

Mousavi Nasim, Momeni Fereshteh, Pourshahbaz Abbas, Poursharifi Hamid, Daneshian Zahra, Andersson Gerhard

机构信息

Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Shahid Beheshti University, Tehran, Iran.

出版信息

Front Psychiatry. 2025 Aug 18;16:1500214. doi: 10.3389/fpsyt.2025.1500214. eCollection 2025.

Abstract

OBJECTIVE

The use of internet-based treatments has increased significantly in recent years. As remote technologies continue to evolve, psychotherapy research is progressively shifting toward these approaches. Anxiety and depressive disorders are highly prevalent in adolescents, imposing significant personal and societal costs. Identifying effective and scalable treatments for this age group is therefore essential. This study aimed to compare the efficacy of face-to-face and internet-based unified transdiagnostic treatment in reducing symptoms and improving functioning in adolescents with anxiety and depressive disorders.

METHODS

A pilot randomized controlled trial (RCT) with pre-test, post-test, and follow-up assessments was conducted to compare the efficacy of face-to-face and internet-based treatments. Forty-nine adolescents (aged 13-18 years) from Tehran, Alborz, Gilan, and Kerman were randomly assigned to one of three groups. Assessments were conducted before treatment, after treatment, and at six months post-treatment. A Mixed-model Analysis of Variance was used for data analysis.

RESULTS

Both face-to-face and internet-based transdiagnostic treatments demonstrated similar efficacy in reducing anxiety and depression symptoms, improving functioning, decreasing negative affect, and reducing avoidance in adolescents. However, neither treatment significantly improved positive affect or distress tolerance. Additionally, the effects in the internet-based group were maintained through the follow-up phase, while the face-to-face treatment group did not sustain these results by the six-month follow-up.

CONCLUSION

Based on the results of this study, internet-based transdiagnostic treatment is also a viable option for treating anxiety and depressive disorders. The large scale implementation of internet-based transdiagnostic psychotherapy could be an effective strategy to bridge the significant gap between adolescents' mental health needs and the availability of evidence-based treatments for anxiety and depression.

CLINICAL TRIAL REGISTRATION

https://irct.behdasht.gov.ir/trial/62220, identifier IRCT20220226054129N1.

摘要

目的

近年来,基于互联网的治疗方法的使用显著增加。随着远程技术的不断发展,心理治疗研究正逐渐转向这些方法。焦虑和抑郁障碍在青少年中非常普遍,给个人和社会带来了巨大的成本。因此,为这个年龄组确定有效且可扩展的治疗方法至关重要。本研究旨在比较面对面和基于互联网的统一跨诊断治疗在减轻焦虑和抑郁障碍青少年的症状及改善其功能方面的疗效。

方法

进行了一项带有预测试、后测试和随访评估的试点随机对照试验(RCT),以比较面对面治疗和基于互联网治疗的疗效。来自德黑兰、阿尔伯兹、吉兰和克尔曼的49名青少年(年龄在13 - 18岁之间)被随机分配到三组中的一组。在治疗前、治疗后和治疗后六个月进行评估。采用混合模型方差分析进行数据分析。

结果

面对面和基于互联网的跨诊断治疗在减轻青少年的焦虑和抑郁症状、改善功能、减少负面影响以及减少回避行为方面都显示出相似的疗效。然而,两种治疗方法均未显著改善积极情绪或痛苦耐受性。此外,基于互联网治疗组的效果在随访阶段得以维持,而面对面治疗组在六个月随访时未维持这些结果。

结论

基于本研究结果,基于互联网的跨诊断治疗也是治疗焦虑和抑郁障碍的可行选择。大规模实施基于互联网的跨诊断心理治疗可能是弥合青少年心理健康需求与焦虑和抑郁循证治疗可及性之间巨大差距的有效策略。

临床试验注册

https://irct.behdasht.gov.ir/trial/62220,标识符IRCT20

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e545/12399596/36a952c79b52/fpsyt-16-1500214-g001.jpg

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