在线跨诊断情绪调节治疗青少年心理健康问题:一项随机临床试验

IF 10.5 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Katja Sjöblom, Katri Frankenstein, Lars Klintwall, Jannike Nilbrink, Maria Zetterqvist, Hugo Hesser, Erik Hedman-Lagerlöf, James J Gross, Clara Hellner, Martin Bellander, Johan Bjureberg
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引用次数: 0

摘要

重要性:心理健康问题在青春期很常见,但获得有效治疗的机会有限。跨诊断治疗可以弥补这一治疗缺口,但其可行性、可接受性和有效性尚不清楚。目的:探讨网络情绪调节治疗青少年心理健康问题的可行性和可接受性,探讨网络情绪调节对青少年心理健康问题的临床效果和目标机制的初步影响。设计、环境和参与者:该单盲随机临床试验于2022年10月16日至2023年7月28日在瑞典的一个初级保健机构进行。意向治疗分析的参与者是12至17岁有心理健康问题的青少年及其父母。干预:参与者以1:1的比例随机分配到治疗师指导的6周在线跨诊断情绪调节治疗或由6周在线支持治疗组成的主动控制条件。主要结局和措施:主要结局是可行性和可接受性措施,包括同意率、评估完成情况、依从性、可信度和期望评分(可信度/期望问卷)以及治疗后立即的治疗满意度(客户满意度问卷)。临床结果由盲法评估者评定,包括整体症状严重程度和改善、抑郁和焦虑症状、整体功能和情绪调节。结果:共30例青少年(平均[SD]年龄14.2[1.48]岁;28名女性(93%)随机分为实验组(n = 15)和主动对照组(n = 15)。同意率(37名符合条件的参与者中有30名[81%])和治疗后立即评估完成率(28名[93%])很高。两组的依从性、可信度、期望和满意度都是足够的。参与实验条件,而不是控制条件,与组内症状严重程度的大幅降低相关(效应量,1.30;95% CI, 0.73-1.86)以及焦虑和抑郁症状(Cohen d, 1.07;95% CI, 0.37-1.84),整体功能改善(Cohen d, 1.26;95% CI, 0.66-1.85),以及适应不良认知应对的减少(Cohen d, 1.10;95% CI, 0.52-1.70)。结论和相关性:在这项随机临床试验中,一种针对有心理健康问题的青少年的简短在线跨诊断情绪调节治疗被发现是可行的、可接受的,并且在初级保健中可能有效,并可能增加这一人群的治疗范围和可及性。试验注册:ClinicalTrials.gov标识符:NCT05032547。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Online Transdiagnostic Emotion Regulation Treatment for Adolescents With Mental Health Problems: A Randomized Clinical Trial.

Importance: Mental health problems are common during adolescence, but access to effective treatments is limited. Transdiagnostic treatments could address this treatment gap, but their feasibility, acceptability, and effectiveness remain unknown.

Objective: To test the feasibility and acceptability of an online emotion regulation treatment for adolescents with mental health problems and investigate the preliminary effects on clinical outcomes and the target mechanism, emotion regulation.

Design, setting, and participants: This single-blind randomized clinical trial was conducted between October 16, 2022, and July 28, 2023, in a primary care setting in Sweden. Participants in the intention-to-treat analysis were adolescents aged 12 to 17 years with mental health problems and their parents.

Intervention: Participants were randomized 1:1 to 6 weeks of therapist-guided online transdiagnostic emotion regulation treatment or an active control condition consisting of 6 weeks of online supportive treatment.

Main outcomes and measures: The primary outcomes were feasibility and acceptability measures, including consent rate, completion of assessments, adherence, credibility and expectancy ratings (Credibility/Expectancy Questionnaire), and treatment satisfaction (Client Satisfaction Questionnaire), immediately after treatment. Clinical outcomes, rated by blinded assessor, included global symptom severity and improvement, symptoms of depression and anxiety, global functioning, and emotion regulation.

Results: A total of 30 adolescents (mean [SD] age, 14.2 [1.48] years; 28 females [93%]) were randomized to experimental treatment (n = 15) or active control treatment (n = 15). The consent rate (30 of 37 eligible participants [81%]) and rate of assessment completion immediately after treatment (28 [93%]) were high. Adherence, credibility, expectancy, and satisfaction in both groups were adequate. Participation in the experimental condition, but not the control condition, was associated with large within-group reductions in symptom severity (effect size, 1.30; 95% CI, 0.73-1.86) and symptoms of anxiety and depression (Cohen d, 1.07; 95% CI, 0.37-1.84), improved global functioning (Cohen d, 1.26; 95% CI, 0.66-1.85), and reductions in maladaptive cognitive coping (Cohen d, 1.10; 95% CI, 0.52-1.70) immediately after treatment.

Conclusion and relevance: In this randomized clinical trial, a brief online transdiagnostic emotion regulation treatment targeting adolescents with mental health problems was found to be feasible, acceptable, and potentially efficacious in primary care and may increase treatment outreach and accessibility for this population.

Trial registration: ClinicalTrials.gov Identifier: NCT05032547.

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来源期刊
JAMA Network Open
JAMA Network Open Medicine-General Medicine
CiteScore
16.00
自引率
2.90%
发文量
2126
审稿时长
16 weeks
期刊介绍: JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health. JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
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