背景:认知行为疗法(CBT)可有效治疗焦虑症。由于治疗师的短缺,日本对CBT的可及性受到限制。虽然开源的电子学习系统可以用来创建一个简单的基于互联网的认知行为治疗(ICBT)计划,日本尚未探索这种治疗方法的安全性和门诊接受度.
目的:本研究的目的是调查门诊患者在实施治疗模块和CBT任务时,在CBT治疗师的指导下,是否可以接受并成功完成ICBT计划。由于在日本处于新疗法的初始阶段,本研究旨在以小样本量进行验证.
方法:总共,6成人,包括4名男性参与者和2名女性参与者,参加了一项单臂试验。干预涉及指导ICBT,包括12届会议,包括CBT文本,理解确认测试,和关于认知行为模型的解释性视频,可通过网站访问。治疗师指导参与者访问ICBT计划并使用聊天工具回答他们的问题。主要结果是使用状态特质焦虑量表-特质评估焦虑严重程度。次要结果包括恐慌症严重程度量表,利博维茨社交焦虑量表(LSAS),贝克焦虑量表(BAI),患者健康问卷-9,广泛性焦虑症-7和工作联盟量表-简表(WAI-SF)。使用配对双尾t检验进行统计分析以评估临床症状的变化。最后阶段的WAI-SF总评分用于评估治疗联盟。对于统计分析,总状态特质焦虑量表-特质特征的平均变化,BAI,惊恐障碍严重程度量表,LSAS,使用配对双尾t检验分析患者健康问卷-9和广泛性焦虑症-7评分。假设检验的双侧显著性水平设置为5%,并计算双侧95%CI。
结果:大多数参与者努力参与ICBT项目。未报告不良事件。主要结局的平均总分下降了11.0(SD9.6)分(95%CI-22.2至0.20;对冲g=0.95),但没有统计学意义。评估临床症状的次要结局的平均总分下降,在15.7(SD12.1)点的BAI中观察到显着降低(95%CI-28.4至-3.0;P=0.03;对冲g=1.24)。PDSS和LSAS的平均总分显着下降,由12.0(SD4.24)点(95%CI-50.1至26.1;P=.16;对冲g=1.79)和32.4(SD11.1)点(95%CI-59.7至-4.3;P=.04;对冲g=1.38),分别。在参与者中,67%(n=4)显示治疗反应,50%(n=3)在干预后获得缓解。治疗联盟,使用WAI-SF测量,是温和的。
结论:在日本,指导ICBT治疗惊恐障碍和社交焦虑障碍患者可能是可行的。
背景:大学医院医疗信息网络临床试验注册UMIN0000038118;https://cente6。乌明。AC.jp/cgi-open-bin/ctr/ctr_view。cgi?recptno=R000043439。
BACKGROUND: Cognitive behavioral therapy (CBT) is effective in treating anxiety disorders. Accessibility to CBT has been limited in Japan due to the shortage of
therapists. While an open-source e-learning system can be used to create a simple internet-based cognitive behavioral therapy (ICBT) program, the safety and outpatient acceptance of this treatment approach have not been explored in Japan.
OBJECTIVE: The aim of this study was to investigate whether outpatients with anxiety disorders could accept and successfully complete the ICBT program with guidance by CBT
therapists when implementing therapeutic modules and CBT tasks. Due to being in the initial phase of a novel treatment in Japan, this study was intended for verification with a small sample size.
METHODS: In total, 6 adults, including 4 male participants and 2 female participants, were enrolled in a single-arm trial. The intervention involved guided ICBT comprising 12 sessions, including CBT text, comprehension confirmation tests, and explanatory videos about cognitive behavioral models, accessible through a website. The therapist guided the participants in accessing the ICBT program and answering their questions using a chat tool. The primary outcome was anxiety severity assessed using the State-Trait Anxiety Inventory-Trait. Secondary outcomes included the Panic Disorder Severity Scale, Liebowitz Social Anxiety Scale (LSAS), Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Working Alliance Inventory-Short Form (WAI-SF). Statistical analyses were performed using paired 2-tailed t tests to assess the changes in clinical symptoms. The total WAI-SF score at the final session was used to evaluate the therapeutic alliance. For statistical analyses, mean changes for total State-Trait Anxiety Inventory-Trait, BAI, Panic Disorder Severity Scale, LSAS, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 scores were analyzed using the paired 2-tailed t test. The 2-sided significance level for hypothesis testing was set at 5%, and 2-sided 95% CIs were calculated.
RESULTS: Most participants diligently engaged with the ICBT program. No adverse events were reported. The mean total scores for the primary outcome decreased by 11.0 (SD 9.6) points (95% CI -22.2 to 0.20; Hedges g=0.95), but it was not statistically significant. The mean total scores for the secondary outcomes that assess clinical symptoms decreased, with a significant reduction observed in the BAI of 15.7 (SD 12.1) points (95% CI -28.4 to -3.0; P=.03; Hedges g=1.24). The mean total scores for PDSS and LSAS decreased significantly, by 12.0 (SD 4.24) points (95% CI -50.1 to 26.1; P=.16; Hedges g=1.79) and 32.4 (SD 11.1) points (95% CI -59.7 to -4.3; P=.04; Hedges g=1.38), respectively. Of the participants, 67% (n=4) showed treatment response, and 50% (n=3) achieved remission after the intervention. The therapeutic alliance, measured using the WAI-SF, was moderate.
CONCLUSIONS: Guided ICBT may be feasible for the treatment of outpatients with panic disorder and social anxiety disorder in Japan.
BACKGROUND: University Hospital Medical Information Network Clinical Trials Registry UMIN0000038118; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043439.