@文章{信息:doi/10.2196/18723，作者=“Lungu, Anita and Jun, Janie Jihee and Azarmanesh, Okhtay and Leykin, Yan and Chen, Connie E-Jean”，标题=“混合护理-认知行为疗法在现实环境中的抑郁和焦虑:语用回顾性研究”，期刊=“J Med Internet Res”，年=“2020”，月=“7”，日=“6”，卷=“22”，数=“7”，页=“e18723”，关键词=“认知行为疗法”;混合心理治疗;传播;实施;抑郁症;焦虑/焦虑症;互联网;基于web的;背景:在过去的几十年里，基于证据的心理疗法的研究和传播取得了相当大的进展，但现有的治疗资源无法满足对抑郁症或焦虑症患者的高度护理需求。混合护理心理治疗结合了治疗师主导和互联网干预的优势，可以缩小这一差距，并且在临床上是有效和高效的，但很少在受控研究环境之外进行评估。 Objective: This study evaluated the effectiveness of a blended care intervention (video-based cognitive behavior therapy and internet intervention) under real-world conditions. Methods: This is a pragmatic retrospective cohort analysis of 385 participants with clinical range depression and/or anxiety symptoms at baseline, measured using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), who enrolled in blended care psychotherapy treatment. Participants resided in the United States and had access to the blended care intervention as a mental health benefit offered through their employers. Levels of depression and anxiety were tracked throughout treatment. Hierarchical linear modeling was used to examine the change in symptoms over time. The effects of age, gender, and providers on participants' symptom change trajectories were also evaluated. Paired sample t-tests were also conducted, and rates of positive clinical change and clinically significant improvement were calculated. Results: The average depression and anxiety symptoms at 6 weeks after the start of treatment were 5.94 and 6.57, respectively. There were significant linear effects of time on both symptoms of depression and anxiety ($\beta$=--.49, P<.001 and $\beta$=--.64, P<.001). The quadratic effect was also significant for both symptoms of depression and anxiety ($\beta$=.04, P<.001 for both), suggesting a decelerated decrease in symptoms over time. Approximately 73{\%} (n=283) of all 385 participants demonstrated reliable improvement, and 83{\%} (n=319) recovered on either the PHQ-9 or GAD-7 measures. Large effect sizes were observed on both symptoms of depression (Cohen d=1.08) and of anxiety (d=1.33). Conclusions: Video blended care cognitive behavioral therapy interventions can be effective and efficient in treating symptoms of depression and anxiety in real-world conditions. Future research should investigate the differential and interactive contribution of the therapist-led and digital components of care to patient outcomes to optimize care. ", issn="1438-8871", doi="10.2196/18723", url="//www.mybigtv.com/2020/7/e18723", url="https://doi.org/10.2196/18723", url="http://www.ncbi.nlm.nih.gov/pubmed/32628120" }