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Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial
Internet Interventions ( IF 5.358 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.invent.2020.100310
Natalie Kladnitski 1 , Jessica Smith 1 , Shivani Uppal 1 , Mathew A James 1 , Adrian R Allen 1 , Gavin Andrews 1 , Jill M Newby 1, 2
Affiliation  

Aim To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression. Method Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K−10), and diagnostic status at the 3-month follow-up (intervention groups). Results All three programs achieved significant and large reductions in symptoms of depression (g = 0.89–1.53), anxiety (g = 1.04–1.40), and distress (g = 1.25–1.76); and medium to large reductions in functional impairment (g = 0.53–0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89–1.18) and anxiety (g = 1.00–1.23). Conclusion Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

中文翻译:

跨诊断互联网提供的 CBT 和基于正念的抑郁和焦虑治疗:一项随机对照试验

目的 与常规护理对照组 (TAU) 相比,检验跨诊断互联网提供的认知行为疗法 (iCBT)、正念增强 iCBT 和独立在线正念训练对临床焦虑和抑郁的疗效。方法 将 DSM-5 诊断为抑郁和/或焦虑症的个体 (N = 158) 随机分配到三个临床医生指导的在线干预之一,或在 14 周的干预期内 TAU。主要结果是治疗后自我报告的抑郁症(PHQ-9)和焦虑症(GAD-7)严重程度。次要结局包括依从率、功能障碍 (WHODAS-II)、一般痛苦 (K-10) 和 3 个月随访时的诊断状态(干预组)。结果 所有三个项目都显着减少了抑郁症状(g = 0.89–1. 53)、焦虑 (g = 1.04–1.40) 和痛苦 (g = 1.25–1.76);从基线到治疗后和 3 个月的随访,功能障碍(g = 0.53-0.98)的中到大减少。意向治疗线性混合模型显示,所有三个在线程序在减少抑郁症(g = 0.89-1.18)和焦虑症(g = 1.00-1.23)方面都优于常规护理。结论 跨诊断 iCBT、正念增强 iCBT 和在线正念训练对于治疗抑郁症和焦虑症比常规护理更有效,并且代表了这些疾病的一种可获得的治疗选择。意向治疗线性混合模型显示,所有三个在线程序在减少抑郁症(g = 0.89-1.18)和焦虑症(g = 1.00-1.23)方面都优于常规护理。结论 跨诊断 iCBT、正念增强 iCBT 和在线正念训练在治疗抑郁症和焦虑症方面比常规护理更有效,并且代表了这些疾病的一种可获得的治疗选择。意向治疗线性混合模型显示,所有三个在线程序在减少抑郁症(g = 0.89-1.18)和焦虑症(g = 1.00-1.23)方面都优于常规护理。结论 跨诊断 iCBT、正念增强 iCBT 和在线正念训练对于治疗抑郁症和焦虑症比常规护理更有效,并且代表了这些疾病的一种可获得的治疗选择。
更新日期:2020-04-01
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