Background: Given that relapse is common in patients in remission from anxiety and depressive disorders, relapse prevention is needed in the maintenance phase. Although existing psychological relapse prevention interventions have proven to be effective, they are not explicitly based on patients’ preferences. Hence, we developed a blended relapse prevention program based on patients’ preferences, which was delivered in primary care practices by mental health professionals (MHPs). This program comprises contact with MHPs, completion of core and optional online modules (including a relapse prevention plan), and keeping a mood and anxiety diary in which patients can monitor their symptoms. Objective: The aims of this study were to provide insight into (1) usage intensity of the program (over time), (2) the course of symptoms during the 9 months of the study, and (3) the association between usage intensity and the course of symptoms. Methods: The Guided E-healTh for RElapse prevention in Anxiety and Depression (GET READY) program was guided by 54 MHPs working in primary care practices. Patients in remission from anxiety and depressive disorders were included. Demographic and clinical characteristics, including anxiety and depressive symptoms, were collected via questionnaires at baseline and after 3, 6, and 9 months. Log data were collected to assess the usage intensity of the program. Results: A total of 113 patients participated in the study. Twenty-seven patients (23.9%) met the criteria for the minimal usage intensity measure. The core modules were used by ≥70% of the patients, while the optional modules were used by <40% of the patients. Usage decreased quickly over time. Anxiety and depressive symptoms remained stable across the total sample; a minority of 15% (12/79) of patients experienced a relapse in their anxiety symptoms, while 10% (8/79) experienced a relapse in their depressive symptoms. Generalized estimating equations analysis indicated a significant association between more frequent face-to-face contact with the MHPs and an increase in both anxiety symptoms (β=.84, 95% CI .39-1.29) and depressive symptoms (β=1.12, 95% CI 0.45-1.79). Diary entries and the number of completed modules were not significantly associated with the course of symptoms. Conclusions: Although the core modules of the GET READY program were used by most of the patients and all patients saw an MHP at least once, usage decreased quickly over time. Most patients remained stable while participating in the study. The significant association between the frequency of contact and the course of symptoms most likely indicates that those who received more support had more symptoms, and thus, it is questionable whether the support offered by the program was sufficient to prevent these patients from relapsing.

中文翻译：

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复发预防计划的使用强度及其与缓解的焦虑和抑郁患者症状严重程度的关系：前后研究

背景：鉴于焦虑症和抑郁症缓解期患者的复发很常见，因此在维持期需要预防复发。尽管现有的心理复发预防干预已被证明是有效的，但它们并未明确基于患者的偏好。因此，我们根据患者的偏好开发了一个混合的复发预防计划，由心理健康专业人员 (MHP) 在初级保健实践中提供。该计划包括与 MHP 的联系、完成核心和可选的在线模块（包括预防复发计划），以及保持患者可以监测其症状的情绪和焦虑日记。客观的：本研究的目的是深入了解 (1) 程序的使用强度（随着时间的推移），(2) 研究 9 个月期间的症状过程，以及 (3) 使用强度与课程之间的关联的症状。方法：指导性 E-healTh 预防焦虑和抑郁症复发 (GET READY) 计划由 54 名在初级保健实践中工作的 MHP 指导。包括缓解焦虑和抑郁障碍的患者。在基线和 3、6 和 9 个月后通过问卷收集人口统计学和临床​​特征，包括焦虑和抑郁症状。收集日志数据以评估程序的使用强度。结果：共有 113 名患者参与了该研究。27 名患者 (23.9%) 符合最低使用强度测量标准。核心模块被 ≥70% 的患者使用，而可选模块被 <40% 的患者使用。随着时间的推移，使用量迅速下降。焦虑和抑郁症状在整个样本中保持稳定；少数 15% (12/79) 的患者焦虑症状复发，而 10% (8/79) 的抑郁症状复发。广义估计方程分析表明，与 MHP 更频繁的面对面接触与焦虑症状 (β=.84, 95% CI .39-1.29) 和抑郁症状 (β=1.12, 95) 的增加之间存在显着关联% CI 0.45-1.79)。结论：虽然 GET READY 计划的核心模块被大多数患者使用，并且所有患者都至少看过一次 MHP，但随着时间的推移，使用率迅速下降。大多数患者在参与研究时保持稳定。接触频率与症状进程之间的显着关联很可能表明接受更多支持的人有更多症状，因此，该计划提供的支持是否足以防止这些患者复发是值得怀疑的。