Background: The COVID-19 pandemic has led to a notable increase in psychological distress, globally. Oman is no exception to this, with several studies indicating high levels of anxiety and depression among the Omani public. There is a need for adaptive and effective interventions that aim to improve the elevated levels of psychological distress due to the COVID-19 pandemic. Objective: This study aimed to comparatively assess the efficacy of therapist-guided online therapy with that of self-help, internet-based therapy focusing on COVID-19–induced symptoms of anxiety and depression among individuals living in Oman during the COVID-19 pandemic. Methods: This was a 6-week-long pragmatic randomized controlled trial involving 60 participants who were recruited from a study sample surveyed for symptoms of anxiety or depression among the Omani public amid the COVID-19 pandemic. Participants in the intervention group were allocated to receive 1 online session per week for 6 weeks from certified psychotherapists in Oman; these sessions were conducted in Arabic or English. The psychotherapists utilized cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants in the control group received an automatic weekly newsletter via email containing self-help information and tips to cope with distress associated with COVID-19. The information mainly consisted of behavioral tips revolving around the principles of cognitive behavioral therapy and acceptance and commitment therapy. The primary outcome was measured by comparing the change in the mean scores of Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scale from the baseline to the end of the study (ie, after 6 sessions) between the two groups. The secondary outcome was to compare the proportions of participants with depression and anxiety between the two groups. Results: Data from 46 participants were analyzed (intervention group n=22, control group n=24). There was no statistical difference in the baseline characteristics between both groups. Analysis of covariance indicated a significant reduction in the GAD-7 scores (F_1,43=7.307; P=.01) between the two groups after adjusting for baseline scores. GAD-7 scores of participants in the intervention group were considerably more reduced than those of participants in the control group (β=−3.27; P=.01). Moreover, a greater reduction in mean PHQ-9 scores was observed among participants in the intervention group (F_1,43=8.298; P=.006) than those in the control group (β=−4.311; P=.006). Although the levels of anxiety and depression reduced in both study groups, the reduction was higher in the intervention group (P=.049) than in the control group (P=.02). Conclusions: This study provides preliminary evidence to support the efficacy of online therapy for improving the symptoms of anxiety and depression during the COVID-19 crisis in Oman. Therapist-guided online therapy was found to be superior to self-help, internet-based therapy; however, both therapies could be considered as viable options. Trial Registration: ClinicalTrials.gov NCT04378257; https://clinicaltrials.gov/ct2/show/NCT04378257

中文翻译：

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六周治疗师指导的在线治疗与基于互联网的自助治疗COVID-19的疗效-诱发的焦虑和抑郁：开放标签，实用性，随机对照试验

背景： COVID-19大流行导致全球范围内的心理困扰显着增加。阿曼也不例外，多项研究表明阿曼公众中的焦虑和抑郁情绪很高。需要有针对性的有效干预措施，旨在改善由于COVID-19大流行而引起的心理困扰水平的提高。目的：本研究旨在比较以治疗师指导的在线治疗与以COVID-19为基础的基于互联网的自助式治疗的疗效-COVID-19 –在COVID-19大流行期间生活在阿曼的人所引起的焦虑和抑郁症状。方法：这是一个为期6周的实用随机对照试验，涉及60名参与者，这些参与者是从研究样本中招募的，这些样本调查了COVID-19大流行期间阿曼公众中的焦虑或抑郁症状。干预组的参与者被分配为每周接受来自阿曼认证的心理治疗师的在线课程，为期6周。这些会议以阿拉伯文或英文进行。心理治疗师利用认知行为疗法以及接受和承诺疗法干预措施。对照组的参与者通过电子邮件自动收到每周简讯，其中包含自助信息和应付与COVID-19相关的困扰的技巧。这些信息主要包括围绕认知行为治疗以及接受和承诺治疗原则的行为提示。通过比较从基线到研究结束（即6岁后）的患者健康问卷9（PHQ-9）和普通焦虑症7（GAD-7）量表的平均得分变化来测量主要结局。会话）。次要结果是比较两组之间抑郁和焦虑的参与者比例。结果：分析了来自46名参与者的数据（干预组n = 22，对照组n = 24）。两组之间的基线特征无统计学差异。协方差分析表明，在调整基线得分之后，两组之间GAD-7得分显着降低（F _1,43 = 7.307；P = .01）。与对照组相比，干预组参与者的GAD-7得分降低幅度更大（β= -3.27；P = 0.01）。此外，与对照组相比，干预组参与者的平均PHQ-9得分下降幅度更大（F _1.43 = 8.298；P = .006 ）（β= -4.311；P = -0.02）。P = .006）。尽管两个研究组的焦虑和抑郁水平均降低，但干预组的降低量（P = .049）高于对照组（P = .02）。结论：这项研究提供了初步的证据来支持在线治疗在阿曼发生COVID-19危机期间改善焦虑和抑郁症状的功效。发现由治疗师指导的在线治疗优于基于互联网的自助治疗。但是，两种疗法都可以视为可行的选择。试用注册： ClinicalTrials.gov NCT04378257；https://clinicaltrials.gov/ct2/show/NCT04378257