背景:抑郁和焦虑在全球范围内越来越普遍。对治疗的需求增加和临床医生的缺乏导致患者接受第一次治疗的等待时间延长。为了应对这种差距,已发现数字心理健康干预(DMHIs)可有效治疗抑郁症和焦虑症,对于等待面对面心理治疗的患者而言,它可能是有希望的预处理.然而,目前尚不清楚数字干预是否能有效缓解等待接受面对面心理治疗的患者的症状.
目的:本综述旨在综合DMHIs对缓解等待面对面治疗的患者抑郁和焦虑症状的有效性。这篇评论还调查了这些特征,感知的可信度,和DMHI在等待时间的可用性。
方法:在这篇系统综述中,我们搜索了PubMed,PsycINFO,科克伦,和WebofScience进行研究,调查DMHIs在减少等待面对面心理治疗的个体的抑郁或焦虑症状方面的有效性。搜索于2024年6月进行,我们纳入了符合纳入标准并在2024年6月6日之前发表的研究。
结果:在确定的9267条唯一记录中,8项研究符合资格标准,并纳入系统评价。五项研究是随机对照试验(RCTs),3项研究没有。在RCT中,我们发现数字干预减少了抑郁和焦虑症状,但与对照组相比,大多数干预措施并不更有效,对照组参与者只是等待或接受自助书.对于非RCT,干预措施也减少了症状,但是没有控制组,对调查结果的解释是有限的。最后,纳入研究的参与者认为数字干预是可信和有用的,但高辍学率引起了人们对治疗依从性的担忧.
结论:由于在综述的研究中缺乏有效的干预措施,尤其是在RCT中,我们的结果表明,与简单地等待或使用自助书相比,等待列表DMHI并没有更有效.然而,为了得出更可靠的结论,需要更多具有更大样本量的高质量RCT。此外,由于这篇综述揭示了人们对数字干预措施辍学率高的担忧,未来的研究也许可以在干预中采用更个性化和以人为中心的功能来提高用户的参与度,具有提高治疗依从性和有效性的潜力。
BACKGROUND: Depression and anxiety have become increasingly prevalent across the globe. The rising need for treatment and the lack of clinicians has resulted in prolonged waiting times for patients to receive their first session. Responding to this gap, digital mental health interventions (DMHIs) have been found effective in treating depression and anxiety and are potentially promising pretreatments for patients who are awaiting face-to-face psychotherapy. Nevertheless, whether digital interventions effectively alleviate symptoms for patients on waiting lists for face-to-face psychotherapy remains unclear.
OBJECTIVE: This review aimed to synthesize the effectiveness of DMHIs for relieving depression and anxiety symptoms of patients on waiting lists for face-to-face therapy. This review also investigated the features, perceived credibility, and usability of DMHIs during waiting times.
METHODS: In this systematic review, we searched PubMed, PsycINFO, Cochrane, and Web of Science for research studies investigating the effectiveness of DMHIs in reducing either depression or anxiety symptoms among individuals waiting for face-to-face psychotherapy. The search was conducted in June 2024, and we have included the studies that met the inclusion criteria and were published before June 6, 2024.
RESULTS: Of the 9267 unique records identified, 8 studies met the eligibility criteria and were included in the systematic review. Five studies were randomized controlled trials (RCTs), and 3 studies were not. Among the RCTs, we found that digital interventions reduced depression and anxiety symptoms, but the majority of interventions were not more effective compared to the control groups where participants simply waited or received a self-help book. For the non-RCTs, the interventions also reduced symptoms, but without control groups, the interpretation of the findings is limited. Finally, participants in the included studies perceived the digital interventions to be credible and useful, but high dropout rates raised concerns about treatment adherence.
CONCLUSIONS: Due to the lack of effective interventions among the reviewed studies, especially among the RCTs, our results suggest that waiting list DMHIs are not more effective compared to simply waiting or using a self-help book. However, more high-quality RCTs with larger sample sizes are warranted in order to draw a more robust conclusion. Additionally, as this review revealed concerns regarding the high dropout rate in digital interventions, future studies could perhaps adopt more personalized and human-centered functions in interventions to increase user engagement, with the potential to increase treatment adherence and effectiveness.