背景:作为重度抑郁症(MDD)的既定治疗方法,认知行为疗法(CBT)现在以基于互联网的格式实施和评估,当与智能手机应用程序结合时,启用安全文本消息。作为这种基于互联网的CBT(ICBT)方法的补充,短信与依从性和治疗联盟的增加有关。
目的:本研究分析了一项随机对照试验的干预组的数据,该试验评估了24周ICBT治疗MDD(干预组)与标准治疗精神病学(等待名单对照)的对照。此次要分析的目的是评估与ICBT参与者在随机对照试验期间向Navigator-Coaches发送的文本消息的频率和内容有关的MDD症状改善。一般和3个概念类别的文本频率较高(欣赏联盟,联盟建设披露,和协议确认)被假设预测更大的MDD症状改善。
方法:参与者是成瘾和心理健康中心的年轻人(18-30岁)。使用线性回归模型分析了来自20个ICBT完成者的分类文本的频率,以改善MDD症状。文本由2个独立的编码员编码,并使用内容分析进行分类。使用贝克抑郁量表-II(BDI-II)测量MDD症状。
结果:参与者平均发送136条短信。分析表明,BDI-II的改善总体上与文本消息频率呈负相关(β=-0.029,95%CI-0.11至0.048),并且在3个类别中的每个类别中:赞赏联盟(β=-0.096,95%CI-0.80至0.61),联盟建筑披露(β=-0.098,95%CI-0.28至0.084),和协议确认(β=-0.076,95%CI-0.40至0.25)。总之,在统计模型中,短信对BDI-II改善的影响均为负.更多的文本消息似乎与较少的MDD症状改善相关。
结论:本研究不支持概念分类的文本信息与MDD症状改善之间的假设正相关。相反,更多的短信似乎表明治疗获益较少。需要进行更大样本的未来研究,以辨别使用辅助通信模式的ICBT方法中文本消息传递的最佳使用。
背景:临床试验.govNCT03406052;https://www.clinicaltrials.gov/ct2/show/NCT03406052.
BACKGROUND: As an established treatment for major depressive disorder (MDD), cognitive behavioral therapy (CBT) is now implemented and assessed in internet-based formats that, when combined with smartphone apps, enable secure text messaging. As an adjunct to such internet-based CBT (ICBT) approaches, text messaging has been associated with increased adherence and therapeutic alliance.
OBJECTIVE: This study analyzed data from the intervention arm of a randomized control trial evaluating 24-week ICBT for MDD (intervention arm) against standard-care psychiatry (waitlist control). The aim of this secondary analysis was to assess MDD symptom improvement in relation to the frequency and content of text messages sent by ICBT participants to Navigator-Coaches during randomized control trial participation. Higher text frequency in general and in 3 conceptual categories (appreciating alliance, alliance building disclosures, and agreement confirmation) was hypothesized to predict larger MDD symptom improvement.
METHODS: Participants were young adults (18-30 years) from the Centre for Addiction and Mental Health. The frequencies of categorized texts from 20 ICBT completers were analyzed with respect to MDD symptom improvement using linear regression models. Texts were coded by 2 independent coders and categorized using content analysis. MDD symptoms were measured using the Beck Depression Inventory-II (BDI-II).
RESULTS: Participants sent an average of 136 text messages. Analyses indicated that BDI-II improvement was negatively associated with text messaging frequency in general (β=-0.029, 95% CI -0.11 to 0.048) and in each of the 3 categories: appreciating alliance (β=-0.096, 95% CI -0.80 to 0.61), alliance building disclosures (β=-0.098, 95% CI -0.28 to 0.084), and agreement confirmation (β=-0.076, 95% CI -0.40 to 0.25). Altogether, the effect of text messaging on BDI-II improvement was uniformly negative across statistical models. More text messaging appeared associated with less MDD symptom improvement.
CONCLUSIONS: The hypothesized positive associations between conceptually categorized text messages and MDD symptom improvement were not supported in this study. Instead, more text messaging appeared to indicate less treatment benefit. Future studies with larger samples are needed to discern the optimal use of text messaging in ICBT approaches using adjunctive modes of communication.
BACKGROUND: Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052.