CBT for depression: a pilot RCT comparing mobile phone vs. computer

BMC Psychiatry - 2013
Sarah Watts1, Anna Mackenzie1, Cherian Thomas1, Al Griskaitis1, Louise Mewton1, Alishia D. Williams1, Gavin Andrews1
1Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, 394-404 Victoria Street, Darlinghurst, NSW, Australia

Tóm tắt

Abstract Background This paper reports the results of a pilot randomized controlled trial comparing the delivery modality (mobile phone/tablet or fixed computer) of a cognitive behavioural therapy intervention for the treatment of depression. The aim was to establish whether a previously validated computerized program (The Sadness Program) remained efficacious when delivered via a mobile application. Method 35 participants were recruited with Major Depression (80% female) and randomly allocated to access the program using a mobile app (on either a mobile phone or iPad) or a computer. Participants completed 6 lessons, weekly homework assignments, and received weekly email contact from a clinical psychologist or psychiatrist until completion of lesson 2. After lesson 2 email contact was only provided in response to participant request, or in response to a deterioration in psychological distress scores. The primary outcome measure was the Patient Health Questionnaire 9 (PHQ-9). Of the 35 participants recruited, 68.6% completed 6 lessons and 65.7% completed the 3-months follow up. Attrition was handled using mixed-model repeated-measures ANOVA. Results Both the Mobile and Computer Groups were associated with statistically significantly benefits in the PHQ-9 at post-test. At 3 months follow up, the reduction seen for both groups remained significant. Conclusions These results provide evidence to indicate that delivering a CBT program using a mobile application, can result in clinically significant improvements in outcomes for patients with depression. Trial registration Australian New Zealand Clinical Trials Registry ACTRN 12611001257954

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Tài liệu tham khảo

Andrews G, Titov N: Depression is very disabling. Lancet. 2007, 370: 808-809. 10.1016/S0140-6736(07)61393-2.

Cuijpers P, Smit F: Excess mortality in depression: a meta-analysis of community studies. J Affect Disord. 2002, 72: 227-236. 10.1016/S0165-0327(01)00413-X.

Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B: Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007, 370: 851-858. 10.1016/S0140-6736(07)61415-9.

Murray CJL, Lopez AD: The Global Burden of Disease. 1996, Geneva: World Health Organization, Harvard School of Public Health, World Bank

Kessler D, Lewis G, Kaur S, Wiles N, King M, Weich S, Peters T: Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial. Lancet. 2009, 374: 628-634. 10.1016/S0140-6736(09)61257-5.

Kupfer DJ, Frank E, Phillips ML: Major depressive disorder: new clinical, neurobiological, and treatment perspectives. Lancet. 2012, 379: 1045-1055. 10.1016/S0140-6736(11)60602-8.

Ham C, Dixon A, Brooke B: Transforming the delivery of health and social care. The case for fundamental change. 2012, London, England: The King’s Fund

Kessler RC: The costs of depression. Psychiatr Clin North Am. 2012, 35: 1-14. 10.1016/j.psc.2011.11.005.

Cuijpers P, Donker T, van Straten A, Li J, Andersson G: Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychol Med. 2010, 40: 14-

Hedman E, Andersson G, Ljótsson B, Andersson E, Rück C, Mörtberg E, Lindefors N: Internet-based cognitive behaviour therapy vs. Cognitive behavioural group therapy for social anxiety disorder: a randomized controlled Non-inferiority trial. PLoS One. 2011, 6 (3): e18001-10.1371/journal.pone.0018001.

Johansson R, Andersson G: Internet-based psychological treatments for depression. Expert Rev Neurother. 2012, 12 (7): 861-870. 10.1586/ERN.12.63.

Perini S, Titov N, Andrews G: Clinician-assisted Internet-based treatment is effective for depression: Randomized controlled trial. The Royal Australian and New Zealand College of Psychiatrists. 2009, 43: 7-

Titov N, Andrews G, Johnston L, Robinson E, Spence J: Transdiagnostic internet treatment for anxiety disorders: a randomized controlled trial. Behav Res Ther. 2010, 48: 890-899. 10.1016/j.brat.2010.05.014.

Rizvi SL, Dimeff LA, Skutch J, Carroll D, Linehan MM: A pilot study of the DBT coach: an interactive mobile phone application for individuals with borderline personality disorder and substance Use of disorder. Behaviour Therapy. 2011, 42: 589-600. 10.1016/j.beth.2011.01.003.

Morris ME, Kathawala Q, Leen TK, Gorenstein EE, Guilak F, Labhard M, Deleeuw W: Mobile therapy: case study evaluations of a cell phone application for emotional self-awareness. Journal Of Medical Internet Research. 2010, 12: 2 e10-e10.

International Telecommunication Union: The World in 2011 ICT Facts and Figures. 2011, Geneva, Switzerland: ITU, 1-8.

Bang M, Timpka T, Eriksson H, Holm E, Nordin C: Mobile phone computing for in-situ cognitive behavioural therapy. Studies in Health Technology Informatics. 2007, 129: 1078-1082.

Reid SC, Kauer SD, Hearps SJC, Crooke AHD, Khor AS, Sanci LA, Patton GC: A mobile phone application for the assessment and management of youth mental health problems in primary care: a randomised controlled trial. BMC Fam Pract. 2011, 12: 131-doi:10.1186/1471-2296-12-131.

Proudfoot J, Parker G, Pavlovic JD, Manicavasagar V, Adler E, Whitton A: Community attitudes to the appropriation of mobile phones for monitoring and managing depression. Anxiety and stress. J Med Internet Res. 2010, 12: 4-10.2196/jmir.1376.

Larson R, Csikszentimihalyi M: The experience sampling method: new directions for methodology. Social Behavioural Science. 1980, 15: 1-15.

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Dunbar GC: The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998, 59: 22-33.

World Health Organization: Composite International Diagnostic Interview. 1990, Geneva, Switzerland: World Health Organization

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32: 959-976. 10.1017/S0033291702006074.

Kroenke K, Spitzer RL, Williams J: The PHQ-9. Validity of a brief depression severity measure. JGIM: Journal of General Internal Medicine. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.

Zuithoff N, Vergouwe Y, King M, Nazareth I, van Wezep M, Moons K, Geerlings M: The Patient Health Questionnaire-9 for detection of major depressive disorder in primary care: consequences of current thresholds in a crosssectional study. BMC Fam Pract. 2010, 11: 98-10.1186/1471-2296-11-98.

Wittkampf KA, Naeije L, Schene AH, Huyser J, van Weert HC: Diagnostic accuracy of the mood module of the Patient Health Questionnaire: a systematic review. Gen Hosp Psychiatry. 2007, 29: 338-395.

Furukawa T, Kessler RC, Slade T, Andrews G: The performance of the K6 and K10 screening scales for psychological distress in the Australian national survey of mental health and well-being. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences. 2003, 33: 357-362. 10.1017/S0033291702006700.

Beck AT, Steer RA, Brown GK: Beck Depression Inventory-II manual. 1996, San Antonio, TX: Harcourt Brace, 2

Devilly GJ, Borkovec TD: Psychometric properties of the credibility/expectancy questionnaire. Journal of Behaviour Therapy and Experimental Psychiatry. 2000, 31: 73-86. 10.1016/S0005-7916(00)00012-4.

Sheehan DV, Harnett-Sheehan K, Raj BA: The measurement of disability. Int Clin Psychopharmacol. 1996, 11: 89-95.

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