ABSTRACT Cognitive behavioural therapy (CBT) can effectively treat common mental disorders (CMDs), but access to treatment is insufficient. Guided self-help (GSH) CBT has shown effects comparable to face-to-face CBT and may be a resource-efficient treatment alternative. However, not all patients respond to GSH. Learning more about predictors of outcome may increase knowledge regarding which patients respond to GSH. The aim of this study was to investigate predictors of outcome for GSH CBT for patients with CMDs in primary care. Consecutive patients (N = 396) with a principal disorder of depression, anxiety, insomnia or stress-related disorders were included. All patients received GSH CBT. Outcomes were remission status, reliable change and post-treatment depression ratings. Predictors investigated were clinical, demographic and therapy-related variables. Analyses were conducted using logistic and linear regression. Higher educational level predicted remission, higher quality of life ratings predicted remission and decreased depression, and higher age at onset predicted reliable change. Therapy-related variables, i.e. patient adherence to treatment and patients’ and clinicians’ estimation of treatment response, were all related to outcome. More large-scale studies are needed, but the present study points at the importance of therapy-related variables such as monitoring and supporting treatment adherence for an increased chance of remission.

中文翻译：

---

初级保健中常见精神障碍的引导式自助认知行为治疗结果的预测因素

摘要 认知行为疗法（CBT）可以有效治疗常见的精神障碍（CMD），但获得治疗的途径不足。引导式自助 (GSH) CBT 已显示出与面对面 CBT 相当的效果，并且可能是一种资源高效的治疗替代方案。然而，并非所有患者都对 GSH 有反应。了解更多关于结果的预测因素可能会增加关于哪些患者对 GSH 有反应的知识。本研究的目的是调查初级保健 CMD 患者 GSH CBT 预后的预测因素。包括患有抑郁症、焦虑症、失眠症或压力相关疾病的主要疾病的连续患者 (N = 396)。所有患者均接受 GSH CBT。结果是缓解状态、可靠变化和治疗后抑郁评分。研究的预测因子是临床的，人口统计学和治疗相关变量。使用逻辑回归和线性回归进行分析。较高的教育水平可预测缓解，较高的生活质量等级可预测缓解和抑郁症减少，较高的发病年龄可预测可靠的变化。与治疗相关的变量，即患者对治疗的依从性以及患者和临床医生对治疗反应的估计，都与结果相关。需要更多的大规模研究，但本研究指出了与治疗相关的变量的重要性，例如监测和支持治疗依从性以增加缓解机会。较高的发病年龄预测了可靠的变化。与治疗相关的变量，即患者对治疗的依从性以及患者和临床医生对治疗反应的估计，都与结果相关。需要更多的大规模研究，但本研究指出了与治疗相关的变量的重要性，例如监测和支持治疗依从性以增加缓解机会。较高的发病年龄预测了可靠的变化。与治疗相关的变量，即患者对治疗的依从性以及患者和临床医生对治疗反应的估计，都与结果相关。需要更多的大规模研究，但本研究指出了与治疗相关的变量的重要性，例如监测和支持治疗依从性以增加缓解机会。