Digital mental health interventions for anxiety and mood disorders patients: A 24-week follow-up

Renato Mikio Moriya , Mariana Ragassi Urbano , Heber Odebrecht Vargas , Regina Celia Bueno Machado , Robson Zazula , Ana Cecilia Novaes de Oliveira Roldan , Sandra Odebrecht Vargas Nunes
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Abstract

Background

Digital psychoeducational interventions have been used for self-monitoring symptoms and self-care for outpatients with affective and anxiety disorders associated with a history of adverse childhood experiences (ACEs). Outpatients with affective and anxiety disorders were recruited for digital mental health interventions (smartphone app and e-book) with treatment as usual.

Methods

Participants were evaluated at baseline and at 24-week follow-up with digital mental health interventions. Participants were assessed by questionnaire and scales (the 17-item Hamilton Depressive Rating Scale (HDRS17), Hamilton Anxiety Rating Scale (HAM-A), Adverse Childhood Questionnaire, Sheehan Disability Scale, Quality of Life, Perceived Stress Scale, and by anthropometric measures.

Results

153 participants were classified into two groups: (n = 110) participants reported having experienced at least three ACEs (<4ACEs) and (n = 43) reported having experienced four or more (≥4ACEs). At baseline, the ≥ 4ACEs group presented significantly more unstable relationship, lower quality of life, more functional impairment, more perceived stress, higher HAM-A and HDRS17 scores than < 4ACEs group. After 24 weeks, digital psychoeducational interventions improved the practice of physical activity in both groups. Digital technologies improved severity of depressive symptoms in the < 4ACEs group and decreased functional impairment in the ≥ 4ACEs group. Higher scores on HAM-A were associated with more ACEs, HDRS17 > 7 and lack of physical activities.

Conclusion

These findings highlight the importance of screening for ACEs to use digital psychoeducational interventions for reducing depressive symptoms and improving physical activities in outpatients with mood and anxiety disorders.

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焦虑和情绪障碍患者的数字心理健康干预:24周随访
背景数字心理教育干预措施已被用于对有不良儿童经历史的情感和焦虑障碍门诊患者的症状进行自我监测和自我护理。招募患有情感和焦虑障碍的门诊患者进行数字心理健康干预(智能手机应用程序和电子书),并照常治疗。方法在基线和24周随访时对参与者进行数字心理健康干预评估。参与者通过问卷和量表(17项汉密尔顿抑郁量表(HDRS17)、汉密尔顿焦虑量表(HAM-A)、不良儿童问卷、Sheehan残疾量表、生活质量、感知压力量表)和人体测量进行评估。结果153名参与者被分为两组:(n = 110)参与者报告经历了至少三种ACE(<;4ACE)和(n = 43)报告经历过四次或四次以上(≥4ACE)。在基线时 ≥ 4ACE组表现出比对照组更不稳定的关系、更低的生活质量、更多的功能损伤、更多的感知压力、更高的HAM-A和HDRS17评分 <; 4ACE组。24小时后 数周后,数字心理教育干预改善了两组的体育活动实践。数字技术改善了老年人抑郁症状的严重程度 <; 4ACEs组的功能损害 ≥ 4ACE组。HAM-A评分越高,ACE越多,HDRS17 >; 7和缺乏体育活动。结论这些发现强调了筛查ACE的重要性,以使用数字心理教育干预措施来减少情绪和焦虑障碍门诊患者的抑郁症状和改善体育活动。
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