一项随机对照试验:无指导、跨诊断、基于网络的焦虑障碍干预的有效性

IF 4.1 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Anna Baumeister , Lea Schuurmans , Steffen Moritz
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引用次数: 0

摘要

背景和目的焦虑症是最常见的精神疾病,但很少有患者得到适当的治疗,主要是由于治疗的高障碍(例如,等待时间长,害怕污名化)。基于互联网的认知行为疗法(iCBT)项目已经成为解决这一治疗差距的一种有希望的方法,证明了对各种焦虑症的有效性。然而,只有少数研究专门针对非引导iCBT。本试验研究了一项为期六周的跨诊断无指导iCBT干预,旨在减少焦虑和相关症状。方法将318名参与者随机分为干预组和候补对照组,与往常一样进行护理,使用ANCOVAs评估焦虑症状严重程度(主要)和相关次要结局(压力,抑郁和焦虑,生活质量,自尊)的变化。结果干预组的焦虑、压力和抑郁在干预后显著减少,与对照组相比,在中小型效应量(|Hedges's g| = 0.27-0.35)。同时进行的心理治疗对治疗效果有负面影响。结论与常规治疗相比,iCBT方案在减轻焦虑和焦虑相关症状方面总体上是有效的。然而,对于同时接受传统心理治疗的人来说,这个项目似乎没有额外的效果。需要进一步的研究来更详细地调查这一亚组的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anxiety unplugged: Effectiveness of an unguided, transdiagnostic, web-based intervention for anxiety disorders—A randomized controlled trial

Background and aim

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.

Methods

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).

Results

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 g| = 0.27–0.35). Concurrent ongoing psychotherapy negatively modified the treatment effect.

Conclusion

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.
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来源期刊
CiteScore
6.50
自引率
9.30%
发文量
94
审稿时长
6 weeks
期刊介绍: Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions
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