独立智能手机应用程序治疗产后抑郁症的效果:随机对照试验

IF 16.3 1区 医学 Q1 PSYCHIATRY Psychotherapy and Psychosomatics Pub Date : 2024-10-23 DOI:10.1159/000541311
Pedro F Zuccolo,André R Brunoni,Tatiane Borja,Alicia Matijasevich,Guilherme V Polanczyk,Daniel Fatori
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引用次数: 0

摘要

简介:基于认知行为疗法(CBT)的智能手机应用干预是治疗精神障碍的一种很有前景的可扩展替代方法,但其对产后抑郁症的疗效证据却很有限。我们评估了基于 CBT 的独立智能手机应用程序 Motherly 在减轻产后抑郁症状方面的疗效。方法:年龄在 18-40 岁、有产后抑郁症状的女性被随机分配到干预组(Motherly 应用程序)或积极对照组(COMVC 应用程序)。主要结果是治疗后通过爱丁堡产后抑郁量表(EPDS)测量的抑郁症状。次要结果包括焦虑症状、父母压力、睡眠质量、行为激活、反应定向正强化的可用性,以及治疗后和 1 个月随访时的临床改善情况。结果从 2021 年 11 月到 2022 年 8 月,共有 1751 名女性自愿参与,其中 264 人被随机分配,215 人提供了主要结果数据。治疗后各组间无统计学差异:干预组:平均(标清):12.75 (5.52);积极对照组:13.28 (5.32);P = 0.604。干预对一些次要结果的影响具有统计学意义。探索性分析表明,Motherly 应用程序参与度与结果之间存在剂量反应关系。探索性研究结果表明,负面结果可能与应用参与不足有关。与目前的文献一致,我们的研究结果表明,针对产后抑郁的独立应用程序干预还不能在临床实践中实施。
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Efficacy of a Standalone Smartphone Application to Treat Postnatal Depression: A Randomized Controlled Trial.
INTRODUCTION Smartphone app interventions based on cognitive-behavioral therapy (CBT) are promising scalable alternatives for treating mental disorders, but the evidence of their efficacy for postpartum depression is limited. We assessed the efficacy of Motherly, a standalone CBT-based smartphone app, in reducing symptoms of postpartum depression. METHODS Women aged 18-40 with symptoms of postpartum depression were randomized either to intervention (Motherly app) or active control (COMVC app). The primary outcome was symptoms of depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at post-treatment. Secondary outcomes were anxiety symptoms, parental stress, quality of sleep, behavioral activation, availability of response-contingent positive reinforcement, and clinical improvement at post-treatment and 1-month follow-up. Exploratory analyses were performed to investigate if app engagement was associated with treatment response. RESULTS From November 2021 to August 2022, 1,751 women volunteered, of which 264 were randomized, and 215 provided primary outcome data. No statistically significant differences were found between groups at post-treatment: intervention: mean (SD): 12.75 (5.52); active control: 13.28 (5.32); p = 0.604. There was a statistically significant effect of the intervention on some of the secondary outcomes. Exploratory analyses suggest a dose-response relationship between Motherly app engagement and outcomes. CONCLUSION Our standalone app intervention did not significantly reduce postnatal depression symptoms when compared to active control. Exploratory findings suggest that negative findings might be associated with insufficient app engagement. Consistent with current literature, our findings suggest that standalone app interventions for postpartum depression are not ready to be implemented in clinical practice.
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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