@ 1438- 8871% I Gunther Eysenbach基于网络的自助干预对抑郁、焦虑和压力症状的有效性:随机对照试验%A van Straten,Annemieke %A Cuijpers,Pim %A Smits,Niels %+ FPP，临床心理学系，Vrije Universiteit Amsterdam, van der Boechorststraat 1,1081 BT Amsterdam, Netherlands， +31 20 5988970, a.van.straten@psy.vu.nl %K阅读疗法%K心理疗法%K问题解决疗法%K抑郁%K焦虑%K压力%D 2008 %7 25.3.2008 %9原始论文%J J Med Internet Res %G英文%X背景:自助疗法通常能有效减少心理健康问题。我们开发了一种基于解决问题疗法的基于网络的自助干预，可用于患有不同类型共病问题的人:抑郁、焦虑和与工作有关的压力。目的:目的是研究基于网络的自助干预是否在减少抑郁、焦虑和与工作有关的压力(倦怠)方面有效。方法:通过大众媒体招募了213名参与者，并随机分为干预组(n = 107)或等待对照组(n = 106)。网络课程花了4周时间。每周都会自动发送电子邮件给参与者，解释下周的内容和练习。此外，参与者还得到了训练有素的心理学学生的支持，他们通过电子邮件对完成的练习提供反馈。干预的核心要素是参与者学习以结构化的方式处理可解决问题的过程。 At pre-test and post-test, we measured the following primary outcomes: depression (CES-D and MDI), anxiety (SCL-A and HADS), and work-related stress (MBI). Quality of life (EQ-5D) was measured as a secondary outcome. Intention-to-treat analyses were performed. Results: Of the 213 participants, 177 (83.1%) completed the baseline and follow-up questionnaires; missing data were statistically imputed. Of all 107 participants in the intervention group, 9% (n = 10) dropped out before the course started and 55% (n = 59) completed the whole course. Among all participants, the intervention was effective in reducing symptoms of depression (CES-D: Cohen’s d = 0.50, 95% confidence interval (CI) 0.22-0.79; MDI: d = 0.33, 95% CI 0.03-0.63) and anxiety (SCL-A: d = 0.42, 95% CI 0.14-0.70; HADS: d = 0.33, 95% CI 0.04-0.61) as well as in enhancing quality of life (d = 0.31, 95% CI 0.03-0.60). Moreover, a higher percentage of patients in the intervention group experienced a significant improvement in symptoms (CES-D: odds ratio [OR] = 3.5, 95% CI 1.9-6.7; MDI: OR = 3.7, 95% CI 1.4-10.0; SCL-A: OR = 2.1, 95% CI 1.0-4.6; HADS: OR = 3.1, 95% CI 1.6-6.0). Patients in the intervention group also recovered more often (MDI: OR = 2.2; SCL-A: OR = 2.0; HADS < 8), although these results were not statistically significant. The course was less effective for work-related stress, but participants in the intervention group recovered more often from burnout than those in the control group (OR = 4.0, 95% CI 1.2-13.5). Conclusions: We demonstrated statistically and clinically significant effects on symptoms of depression and anxiety. These effects were even more pronounced among participants with more severe baseline problems and for participants who fully completed the course. The effects on work-related stress and quality of life were less clear. To our knowledge, this is the first trial of a Web-based, problem-solving intervention for people with different types of (comorbid) emotional problems. The results are promising, especially for symptoms of depression and anxiety. Further research is needed to enhance the effectiveness for work-related stress. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 14881571 %M 18364344 %R 10.2196/jmir.954 %U //www.mybigtv.com/2008/1/e7/ %U https://doi.org/10.2196/jmir.954 %U http://www.ncbi.nlm.nih.gov/pubmed/18364344