TY - JOUR AU - Milgrom, Jeannette AU - Danaher, Brian G AU - Seeley, John R AU - Holt, Christopher J AU - Holt, Charlene AU - Ericksen, Jennifer AU - Tyler, Milagra S AU - Gau, Jeff M AU - Gemmill, Alan W PY - 2021 DA - 201/12/8 TI -产后抑郁症的互联网和面对面认知行为治疗与常规治疗的比较:MumMoodBooster JO - J Med Internet Res SP - e17185 VL - 23 IS - 12 KW -产后抑郁KW -产后抑郁KW -产后焦虑KW -产后焦虑KW -认知行为治疗KW -互联网干预KW -基于网络的干预KW -随机对照试验KW -在线干预KW -治疗KW -手机AB -背景:先前的研究已经证实，产后抑郁症(PND)的症状可以通过网络提供的心理干预来改善。互联网提供治疗的优势包括匿名性、便捷性和迎合无法接受面对面治疗(FTF)的女性。迄今为止，还没有研究对临床诊断为PND的妇女进行此类干预与FTF治疗的直接比较。目的:在一项随机对照试验(RCT)中，本研究旨在比较首批基于网络的认知行为疗法(CBT)干预措施(互联网CBT+教练呼叫)治疗PND (MumMoodBooster [MMB])与FTF-CBT的疗效。方法:在这项研究中，116名患有精神障碍诊断和统计手册第四版(DSM-IV)诊断为严重或轻微抑郁症的产后妇女被随机分为MMB(39/116, 33.6%)、FTF-CBT(39/116, 33.6%)或常规治疗(TAU)对照组(38/116,32.8%)。根据DSM-IV的结构化临床访谈，在基线和21周随访时确定诊断状态。在基线、治疗后12周随访和21周随访时，使用抑郁焦虑压力量表和修订的贝克抑郁量表评估焦虑和抑郁症状的严重程度。结果:116名参与者中，107名(92.2%)在基线时被诊断为重度抑郁症。 Rates of remission from a major or minor depressive episode at 21 weeks in both the FTF-CBT and MMB groups were superior to that of the TAU group (56.6% and 47.7% less likely to be depressed, respectively) and they were not significantly different from each other. Although remission rates differed between TAU and FTF-CBT, growth models showed that, in terms of symptom reduction across time, the FTF-CBT treatment was not significantly better than TAU. By comparison, MMB was statistically superior to both TAU and FTF-CBT in reducing symptoms of depression, anxiety, and stress from baseline to the 21-week follow-up (large and moderate effect sizes). Thus, after 21 weeks, the average symptom scores for depression and anxiety of women receiving MMB were approximately half those of women in both the TAU and FTF-CBT groups. Conclusions: In this RCT, MMB was at least as effective as FTF-CBT in achieving remission from a diagnosed PND episode. MMB was superior to TAU and FTF-CBT in encouraging and maintaining reduction of symptom severity over the 21-week follow-up for depressed postnatal women. These findings replicate results of prior studies on MMB that showed clinically significant improvements in depressive symptoms, and they provide direct empirical support that internet-delivered treatment for depressed postnatal women is a viable alternative to FTF treatment. The generalizability of the results needs to be examined in future research, as RCTs of internet-based versus FTF treatments necessarily involve a subset of people who are willing to undertake either modality of treatment. Trial Registration: Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000881730; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364683&isReview=true SN - 1438-8871 UR - //www.mybigtv.com/2021/12/e17185 UR - https://doi.org/10.2196/17185 UR - http://www.ncbi.nlm.nih.gov/pubmed/34889742 DO - 10.2196/17185 ID - info:doi/10.2196/17185 ER -