Adjustment disorder with anxiety (ADA) is a common psychiatric pathology worldwide, but it is often undertreated. Cognitive behavioral therapy (CBT) is the first-line treatment, but very few studies have been carried out for the treatment of ADA. Internet-delivered CBT (iCBT) appears to be an effective treatment option, with the potential to reach a larger proportion of individuals suffering from ADA. Guidance is a beneficial feature of iCBT, provided in most studies by email or telephone (traditional guided iCBT). Blended CBT, which combines an online intervention and therapeutic guidance provided in person (face-to-face), could be a way to benefit from both the advantages of face-to-face CBT regarding human interactional quality and the advantages of internet-based CBT in terms of improved access to treatment.

In this randomized controlled trial, the effectiveness of two forms of administration of Seren@ctif, a 5-week CBT program for patients with ADA according the DSM-5, was examined: one delivered through face-to-face sessions (face-to-face CBT) and the other delivered online and guided with face-to-face contact with a nurse (blended CBT); these formats were compared with a wait-list control group (WLC). A total of 120 patients were included and randomized to one of these three conditions. Measures were administered before treatment, after treatment and 6 months after inclusion in the study. Both treatment conditions displayed significant decreases in anxiety, depression, worry and perceived stress at posttreatment when compared to the WLC group. The decrease in symptoms was mostly maintained 6 months after inclusion for the two experimental groups. Blended CBT showed significantly greater reductions in anxiety and depression than did face-to-face CBT on some secondary outcome measures.

We conclude that both face-to-face CBT and blended CBT are effective treatments for patients with ADA, and we suggest that blended CBT may be slightly more effective than classical face-to-face CBT.

Trial Registration: Clinicaltrials.gov NCT02621775;https://clinicaltrials.gov/ct2/show/NCT02621775(Archived by WebCite at http://www.webcitation.org/6tQrkPs1u).

焦虑症适应症（ADA）是全世界常见的精神病学病理学，但常常得不到充分的治疗。认知行为疗法（CBT）是一线治疗，但是针对ADA的治疗研究很少。互联网提供的CBT（iCBT）似乎是一种有效的治疗选择，有可能覆盖更多患有ADA的个体。指导是iCBT的一项有益功能，在大多数研究中都是通过电子邮件或电话（传统指导iCBT）提供的。混合式CBT结合了在线干预和亲自提供的治疗指导（面对面），可能是一种既受益于面对面CBT的人际互动质量优势又基于互联网的优势的方式在改善获得治疗方面的CBT。

在这项随机对照试验中，Seren @ ctif两种给药方式的有效性，根据DSM-5对ADA患者进行的为期5周的CBT计划进行了检查：一项是通过面对面会议（面对面CBT）交付，另一项是在线交付并以面对面指导与护士接触（混合CBT）；将这些格式与等待列表对照组（WLC）进行了比较。总共包括120名患者，并随机分配到这三种情况之一。在治疗前，治疗后和纳入研究后6个月内采取措施。与WLC组相比，两种治疗条件在治疗后均显示焦虑，抑郁，忧虑和感觉到的压力显着降低。两个实验组入组后6个月，症状的减轻大部分得以维持。

我们得出结论，面对面CBT和混合CBT对ADA患者都是有效的治疗方法，并且我们建议混合CBT可能比经典的面对面CBT稍微有效。

试用注册：Clinicaltrials.gov NCT02621775; https：//clinicaltrials.gov/ct2/show/NCT02621775（由WebCite存档于http://www.webcitation.org/6tQrkPs1u）。