@文章{info:doi/10.2196/12091，作者=“松本，一树和须藤，千弘和浅野，研一和关，洋一和浦尾，优子和横oo，水和高桥，理子和吉田，丰子和田中，Mari和野口，雷和永田，新信和大井，惠子和新田，纪子和广濑，元久和吉村，健介和永井，和藤和佐藤，泰弘和中川，明子和清水，英二”，标题=“基于网络的认知行为疗法，通过视频会议为强迫症、恐慌症和社交焦虑症患者提供实时治疗师支持:试点单臂试验”，期刊=“J Med Internet Res”，年=“2018”，月=“12”，日=“17”，卷=“20”，数=“12”，页=“e12091”，关键词=“临床试验;认知行为疗法;可行性研究;强迫症;恐慌症;社交焦虑障碍;背景:认知行为疗法(CBT)是成人强迫症(OCD)、惊恐障碍(PD)和社交焦虑障碍(SAD)的一线治疗方法。农村地区的患者可以通过互联网接受CBT治疗。网络传递的认知行为治疗(ICBT)的有效性已经得到了一致的证明，但没有临床研究证明通过视频会议的实时治疗师支持同时用于强迫症、PD和SAD的ICBT的可行性。 Objectives: This study aimed to evaluate the feasibility of videoconference-delivered CBT for patients with OCD, PD, or SAD. Methods: A total of 30 Japanese participants (mean age 35.4 years, SD 9.2) with OCD, SAD, or PD received 16 sessions of individualized videoconference-delivered CBT with real-time support of a therapist, using tablet personal computer (Apple iPad Mini 2). Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. The primary outcomes were reduction in symptomatology, using the Yale-Brown obsessive-compulsive scale (Y-BOCS) for OCD, Panic Disorder Severity Scale (PDSS) for PD, and Liebowitz Social Anxiety Scale (LSAS) for SAD. The secondary outcomes included the EuroQol-5 Dimension (EQ-5D) for Quality of Life, the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder (GAD-7) questionnaire for anxiety, and Working Alliance Inventory-Short Form (WAI-SF). All primary outcomes were assessed at baseline and at weeks 1 (baseline), 8 (midintervention), and 16 (postintervention) face-to-face during therapy. The occurrence of adverse events was observed after each session. For the primary analysis comparing between pre- and posttreatments, the participants' points and 95{\%} CIs were estimated by the paired t tests with the change between pre- and posttreatment. Results: A significant reduction in symptom of obsession-compulsion (Y-BOCS=−6.2; Cohen d=0.74; 95{\%} CI −9.4 to −3.0, P=.002), panic (PDSS=−5.6; Cohen d=0.89; 95{\%} CI −9.83 to −1.37; P=.02), social anxiety (LSAS=−33.6; Cohen d=1.10; 95{\%} CI −59.62 to −7.49, P=.02) were observed. In addition, depression (PHQ-9=−1.72; Cohen d=0.27; 95{\%} CI −3.26 to −0.19; P=.03) and general anxiety (GAD-7=−3.03; Cohen d=0.61; 95{\%} CI −4.57 to −1.49, P<.001) were significantly improved. Although there were no significant changes at 16 weeks from baseline in EQ-5D (0.0336; Cohen d=-0.202; 95{\%} CI −0.0198 to 0.00869; P=.21), there were high therapeutic alliance (ie, WAI-SF) scores (from 68.0 to 73.7) throughout treatment, which significantly increased (4.14; 95{\%} CI 1.24 to 7.04; P=.007). Of the participants, 86{\%} (25/29) were satisfied with videoconference-delivered CBT, and 83{\%} (24/29) preferred videoconference-delivered CBT to face-to-face CBT. An adverse event occurred to a patient with SAD; the incidence was 3{\%} (1/30). Conclusions: Videoconference-delivered CBT for patients with OCD, SAD, and SAD may be feasible and acceptable. ", issn="1438-8871", doi="10.2196/12091", url="//www.mybigtv.com/2018/12/e12091/", url="https://doi.org/10.2196/12091", url="http://www.ncbi.nlm.nih.gov/pubmed/30559094" }