y - JOUR AU - Imamura, AU - Kotaro AU - Furukawa, Toshi A - Matsuyama, Yutaka AU - Shimazu, Akihito AU - Kuribayashi, Kazuto Kasai, Kiyoto AU - Kawakami, Norito PY - 2018 DA - 2018/08/10 TI -基于网络的认知行为疗法改善员工非临床抑郁症状的效果差异:随机对照试验JO - J Med Internet Res SP - e10231 VL - 20 IS - 8 KW -基于互联网的计算机化认知行为治疗KW -时间偏好KW -非临床抑郁症状KW -工作者AB -先前的随机对照试验(RCTs)显示了基于互联网的计算机化认知行为疗法(iCBT)对改善初级预防环境中健康工作者和社区居民的非临床抑郁症状的显著干预效果。时间偏好是一个人对目前获得奖励(如金钱)比以后获得奖励的相对评价。时间偏好可能影响认知行为治疗的效果。目的:本随机对照试验旨在检验iCBT项目对改善日本工人非临床抑郁症状的干预效果在两个基于时间偏好的事后分类亚组之间的差异。方法:在一个企业集团中招募所有工人(约n=20,000)。符合纳入标准的参与者被随机分配到干预组或对照组。干预组的参与者在iCBT项目中完成了6周的课程和家庭作业。在基线和3个月、6个月和12个月的随访中获得贝克抑郁量表- ii (BDI-II)和凯斯勒心理困扰量表(K6)测量。 Two subgroups were defined by the median of time preference score at baseline. Results: Only few (835/20,000, 4.2%) workers completed the baseline survey. Of the 835 participants, 706 who fulfilled the inclusion criteria were randomly allocated to the intervention or control group. Participants who selected irrational time preference options were excluded (21 and 18 participants in the intervention and control groups, respectively). A three-way interaction (group [intervention/control] × time [baseline/follow-up] × time preference [higher/lower]) effect of iCBT was significant for BDI-II (t1147.42=2.33, P=.02) and K6 (t1254.04=2.51, P=.01) at the 3-month follow-up, with a greater effect of the iCBT in the group with higher time preference. No significant three-way interaction was found at the 6- and 12-month follow-ups. Conclusions: The effects of the iCBT were greater for the group with higher time preference at the shorter follow-up, but it was leveled off later. Workers with higher time preference may change their cognition or behavior more quickly, but these changes may not persist. Trial Registration: UMIN Clinical Trials Registry UMIN000014146; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000016466 (Archived by WebCite at http://www.webcitation.org/70o2rNk2V) SN - 1438-8871 UR - //www.mybigtv.com/2018/8/e10231/ UR - https://doi.org/10.2196/10231 UR - http://www.ncbi.nlm.nih.gov/pubmed/30097419 DO - 10.2196/10231 ID - info:doi/10.2196/10231 ER -