Internet-based cognitive behavior therapy (ICBT) has proved effective in reducing mild to moderate depressive symptoms. However, only a few studies have been conducted in a regular healthcare setting which limits the generalizability of the results. The influence of psychiatric comorbidity on outcome is not well understood. In the current study, patients with mild to moderate depressive symptoms in primary and psychiatric care were interviewed using the SCID-I and SCID-II to assess psychiatric diagnoses. Those included were randomly allocated to ICBT (n = 48) or to an active control condition (n = 47). Both groups received therapist support. At post-treatment, ICBT had reduced depressive symptoms on the BDI-II more than the active control intervention (p = .021). However, the difference between groups was no longer significant at the 6-, 12- or 24-month follow-ups. The within-group effect size after ICBT (BDI-II) was large (d = 1.4). A comorbid anxiety disorder didn't moderate the outcome, while the presence of a personality disorder predicted significantly less improvement in depressive symptoms. ICBT had a large effect on depressive symptoms in a sample from regular healthcare. It is possible to obtain a large effect from ICBT despite comorbid anxiety, however, including patients with a comorbid personality disorder in the current form of ICBT seems questionable.

中文翻译：

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在初级和精神科护理中为抑郁症患者提供的基于Internet的CBT：是否有效，合并症是否会影响预后？

基于互联网的认知行为疗法（ICBT）已被证明可以有效减轻轻度至中度的抑郁症状。但是，在常规的医疗机构中仅进行了很少的研究，这限制了结果的推广性。精神病合并症对预后的影响尚不清楚。在当前的研究中，使用SCID-I和SCID-II对初级和精神病学治疗中轻度至中度抑郁症状的患者进行了访谈，以评估精神病学诊断。包括在内的那些被随机分配到ICBT（n = 48）或主动控制状态（n = 47）。两组都得到了治疗师的支持。在治疗后，ICBT减轻了BDI-II的抑郁症状，超过了主动控制干预（p = .021）。但是，两组之间的差异在6岁时不再显着，12或24个月的随访。ICBT（BDI-II）后的组内效应大小较大（d = 1.4）。合并症焦虑症并不能缓解结局，而人格障碍的存在预示着抑郁症状的改善明显较少。ICBT对常规医疗机构的样本中的抑郁症状有很大影响。尽管存在合并症焦虑症，仍可以从ICBT取得很大的疗效，但是，包括目前以ICBT形式存在的合并症人格障碍患者似乎值得怀疑。ICBT对常规医疗机构的样本中的抑郁症状有很大影响。尽管存在合并症焦虑症，仍可以从ICBT取得很大的疗效，但是，包括目前以ICBT形式存在的合并症人格障碍患者似乎值得怀疑。ICBT对常规医疗机构的样本中的抑郁症状有很大影响。尽管存在合并症焦虑症，仍可以从ICBT取得很大的疗效，但是，包括目前以ICBT形式存在的合并症人格障碍患者似乎值得怀疑。