@文章{info:doi/10.2196/26814，作者="P{\'e}rez, J Carola和Fern{\'a}ndez, Olga和C{\'a}ceres, Cristi{\'a}n和Carrasco， {\'a} lvaro e和Moessner, Markus和Bauer, Stephanie和Espinosa-Duque, Daniel和Gloger, Sergio和Krause, Mariane"，标题="一种基于互联网的辅助干预，增强成人抑郁症的治疗:随机对照试验"，期刊="JMIR Ment Health"，年="2021"，月="12"，日="16"，卷="8"，数="12"，页数="e26814"，关键词="抑郁症;e-mental健康;混合护理;背景:基于互联网的干预措施有望提高更多人和更偏远地区获得精神卫生保健的可及性。它们的有效性已被证明可以预防和治疗各种精神障碍。然而，当它们作为常规治疗(即混合治疗)的附加治疗时，其潜力就不那么清楚了。目的:本研究的目的是研究除面对面常规治疗(TAU)外，网络干预(ASCENSO)对抑郁症的有效性。方法:在智利的一家门诊私人精神卫生保健中心进行了一项两臂、平行组、随机对照试验。总共有167名成年人被诊断为重度抑郁症，没有严重的共病，并且可以上网。 Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider--assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center's internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results: Of the 84 participants in the intervention group, 5 participants (6{\%}) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1{\%}, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91{\%}) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54{\%} (45/84) for the intervention group versus 39{\%} (32/83) for the control group (P=.07). Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients' limited use of the online platform. Trial Registration: ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467 ", issn="2368-7959", doi="10.2196/26814", url="https://mental.www.mybigtv.com/2021/12/e26814", url="https://doi.org/10.2196/26814", url="http://www.ncbi.nlm.nih.gov/pubmed/34927594" }