Till Langhammer, Kevin Hilbert, Robert Wasenmueller, Berit Praxl, Andrea Ertle, Julia Asbrand, Ulrike Lueken
{"title":"评估 COVID-19 大流行期间基于 CBT 的普通人群心理健康计划：使用聊天机器人和数字化小组干预的阶梯式护理方法","authors":"Till Langhammer, Kevin Hilbert, Robert Wasenmueller, Berit Praxl, Andrea Ertle, Julia Asbrand, Ulrike Lueken","doi":"10.1155/2024/8950388","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> The COVID-19 pandemic exposed a substantial portion of society to multiple stressors, while access to mental health care was limited. To address this, we introduced a digital stepped-care program rooted in cognitive–behavioral therapy (CBT) principles, aiming to alleviate mental health distress among the general public seeking help.</p>\n <p><b>Methods:</b> The program comprises a 4-week digital application using “Aury” the chatbot, followed by an optional 6-week online group session for those still symptomatic. A 4-week waiting period separated these steps. Participants entered based on self-identified mental health concerns. Interventions addressed prevalent pandemic mental health issues: sleep disturbances, anxiety, depression, worry/rumination, interpersonal issues, and resource mobilization. Outcomes focused on depressive, anxiety, and somatic symptoms, assessed by the Patient Health Questionnaire (PHQ).</p>\n <p><b>Results:</b> Of the 1261 initial participants, postchatbot results (<i>N</i> = 142) indicated small to medium effects (<i>d</i> = 0.412 to <i>d</i> = 0.523). Those finishing the entire program (<i>N</i> = 41) saw substantial symptom decline with medium to large effects (<i>d</i> = 0.757 to <i>d</i> = 0.818). No shifts were seen in the waiting phase. At follow-up 6 months after baseline, both groups—those who only used the chatbot (<i>N</i> = 60; <i>d</i> = 0.284 to <i>d</i> = 0.416) and those who completed the entire program (<i>N</i> = 27; <i>d</i> = 0.854 to <i>d</i> = 0.926)—showed sustained symptom reduction. Comparing groups that received no intervention, used the chatbot only, and completed the entire program, we observed a dose–response effect.</p>\n <p><b>Conclusions:</b> This resource-efficient and adaptable digital approach effectively reduced pandemic-induced mental health issues, indicating its potential in crisis periods with limited health resources. Randomized controlled trials are recommended for further validation.</p>\n <p><b>Trial Registration:</b> Clinical Trial Registry identifier: DRKS00023220.</p>\n </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2024 1","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8950388","citationCount":"0","resultStr":"{\"title\":\"Evaluation of a CBT-Based Program for Mental Health in the General Population During the COVID-19 Pandemic: A Stepped-Care Approach Using a Chatbot and Digitized Group Intervention\",\"authors\":\"Till Langhammer, Kevin Hilbert, Robert Wasenmueller, Berit Praxl, Andrea Ertle, Julia Asbrand, Ulrike Lueken\",\"doi\":\"10.1155/2024/8950388\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> The COVID-19 pandemic exposed a substantial portion of society to multiple stressors, while access to mental health care was limited. To address this, we introduced a digital stepped-care program rooted in cognitive–behavioral therapy (CBT) principles, aiming to alleviate mental health distress among the general public seeking help.</p>\\n <p><b>Methods:</b> The program comprises a 4-week digital application using “Aury” the chatbot, followed by an optional 6-week online group session for those still symptomatic. A 4-week waiting period separated these steps. Participants entered based on self-identified mental health concerns. Interventions addressed prevalent pandemic mental health issues: sleep disturbances, anxiety, depression, worry/rumination, interpersonal issues, and resource mobilization. Outcomes focused on depressive, anxiety, and somatic symptoms, assessed by the Patient Health Questionnaire (PHQ).</p>\\n <p><b>Results:</b> Of the 1261 initial participants, postchatbot results (<i>N</i> = 142) indicated small to medium effects (<i>d</i> = 0.412 to <i>d</i> = 0.523). Those finishing the entire program (<i>N</i> = 41) saw substantial symptom decline with medium to large effects (<i>d</i> = 0.757 to <i>d</i> = 0.818). No shifts were seen in the waiting phase. At follow-up 6 months after baseline, both groups—those who only used the chatbot (<i>N</i> = 60; <i>d</i> = 0.284 to <i>d</i> = 0.416) and those who completed the entire program (<i>N</i> = 27; <i>d</i> = 0.854 to <i>d</i> = 0.926)—showed sustained symptom reduction. Comparing groups that received no intervention, used the chatbot only, and completed the entire program, we observed a dose–response effect.</p>\\n <p><b>Conclusions:</b> This resource-efficient and adaptable digital approach effectively reduced pandemic-induced mental health issues, indicating its potential in crisis periods with limited health resources. Randomized controlled trials are recommended for further validation.</p>\\n <p><b>Trial Registration:</b> Clinical Trial Registry identifier: DRKS00023220.</p>\\n </div>\",\"PeriodicalId\":55179,\"journal\":{\"name\":\"Depression and Anxiety\",\"volume\":\"2024 1\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/8950388\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Depression and Anxiety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/2024/8950388\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Depression and Anxiety","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/2024/8950388","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Evaluation of a CBT-Based Program for Mental Health in the General Population During the COVID-19 Pandemic: A Stepped-Care Approach Using a Chatbot and Digitized Group Intervention
Background: The COVID-19 pandemic exposed a substantial portion of society to multiple stressors, while access to mental health care was limited. To address this, we introduced a digital stepped-care program rooted in cognitive–behavioral therapy (CBT) principles, aiming to alleviate mental health distress among the general public seeking help.
Methods: The program comprises a 4-week digital application using “Aury” the chatbot, followed by an optional 6-week online group session for those still symptomatic. A 4-week waiting period separated these steps. Participants entered based on self-identified mental health concerns. Interventions addressed prevalent pandemic mental health issues: sleep disturbances, anxiety, depression, worry/rumination, interpersonal issues, and resource mobilization. Outcomes focused on depressive, anxiety, and somatic symptoms, assessed by the Patient Health Questionnaire (PHQ).
Results: Of the 1261 initial participants, postchatbot results (N = 142) indicated small to medium effects (d = 0.412 to d = 0.523). Those finishing the entire program (N = 41) saw substantial symptom decline with medium to large effects (d = 0.757 to d = 0.818). No shifts were seen in the waiting phase. At follow-up 6 months after baseline, both groups—those who only used the chatbot (N = 60; d = 0.284 to d = 0.416) and those who completed the entire program (N = 27; d = 0.854 to d = 0.926)—showed sustained symptom reduction. Comparing groups that received no intervention, used the chatbot only, and completed the entire program, we observed a dose–response effect.
Conclusions: This resource-efficient and adaptable digital approach effectively reduced pandemic-induced mental health issues, indicating its potential in crisis periods with limited health resources. Randomized controlled trials are recommended for further validation.
期刊介绍：
Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.
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