J Child Psychol Psyc:MEMO CET对青春期抑郁症干预疗效如何?

2017-06-06 MedSci MedSci原创

抑郁症经常在青春期发生,因此青春期阶段为抑郁症干预的理想时间。近日发表在Journal of Child Psychology and Psychiatry上的一项研究针对青少年抑郁症的干预治疗开展试验。值得注意的是,这项研究的开展者开发了一种通用的认知行为治疗方案(MEMO CBT),并将这种治疗方案通过多媒体手机信息传递给了青少年。以下是这项试验的简要介绍。

抑郁症经常在青春期发生,因此青春期阶段为抑郁症干预的理想时间。近日发表在Journal of Child Psychology and Psychiatry上的一项研究针对青少年抑郁症的干预治疗开展试验。值得注意的是,这项研究的开展者开发了一种通用的认知行为治疗方案(MEMO CBT),并将这种治疗方案通过多媒体手机信息传递给了青少年。以下是这项试验的简要介绍。

试验在新西兰奥克兰的15所高中开展。研究者进行了一项前瞻性多中心,随机,安慰剂对照优质试验,将MEMO CBT与一种控制程序[MEMO控制]进行对照,MEMO控制主要对消息的强度和类型进行匹配,但是该程序却没有针对抑郁症的替代内容。这项试验的主要研究内容是观察儿童抑郁评分量表从基线到12个月的评分变化情况。次要内容包括雷诺兹青少年自我报告抑郁评定量表第二版的变化情况,情绪和感觉问卷调查表中的分数变化,青少年风险行为的自杀意念调查分数变化,小儿生活质量问卷调查表分数变化,12个月期间应用“情感障碍和精神分裂症儿童日程表”诊断抑郁症患病率情况,以及学生对该方案的满意程度。

在实验过程中,八百五十五名学生(13-17岁,平均14.3岁)被随机分配到MEMO CBT(426)或MEMO Control(429)组。其中对于干预组394例(93%)和对照组392例(91%)进行了12个月的随访。研究数据显示:参与者(68%女性)平均CDRS-R基线为21.5(SD:5)。在干预结束时(约9周),干预组的平均CDRS-R评分为20.8,对照组为20.4;在12个月时干预组为22.4,对照组为22.4(基线变化差异p值为0.3 )。另外,参与者的干预量与结果之间没有明显的联系。

与控制程序相比,手机CBT干预没有体现优势。目前抑郁预防对人类来说仍然是一个挑战。

原始出处:

Robyn Whittaker,Karolina Stasiak, et al. MEMO: an mHealth intervention to prevent the onset of depression in adolescents: a double-blind, randomised, placebo-controlled trial. Journal of Child Psychology and Psychiatry 2 June 2017 DOI: 10.1111/jcpp.12753

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