Effectiveness of Peer-Supported Computer-Based CBT for Depression Among Veterans in Primary Care

被引:23
作者
Pfeiffer, Paul N. [1 ,2 ]
Pope, Brooke [3 ]
Houck, Marc [3 ]
Benn-Burton, Wendy [4 ]
Zivin, Kara [1 ,2 ]
Ganoczy, Dara [1 ]
Kim, H. Myra [1 ,5 ]
Walters, Heather [1 ,2 ]
Emerson, Lauren [1 ,2 ]
Nelson, C. Beau [1 ,2 ]
Abraham, Kristen M. [1 ,6 ]
Valenstein, Marcia [1 ,2 ]
机构
[1] VA Ann Arbor Healthcare Syst, US Dept Vet Affairs, Ann Arbor, MI 48105 USA
[2] Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI 48109 USA
[3] Battle Creek VA Med Ctr, Battle Creek, MI USA
[4] John D Dingell VA Med Ctr, Detroit, MI USA
[5] Univ Michigan, Stat Comp & Analyt Res, Ann Arbor, MI 48109 USA
[6] Univ Detroit Mercy, Dept Psychol, Detroit, MI 48221 USA
关键词
COGNITIVE-BEHAVIORAL THERAPY; 16-ITEM QUICK INVENTORY; REPORT QIDS-SR; HEALTH-CARE; SYMPTOMATOLOGY; METAANALYSIS; PREFERENCES; VALIDATION; SYMPTOMS; BARRIERS;
D O I
10.1176/appi.ps.201900283
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: This study tested whether computerized cognitive-behavioral therapy for depression supported by a peer specialist with lived experience of depression (PS-cCBT) improves mental health-related outcomes for primary care patients. Methods: In the U.S. Department of Veterans Affairs, primary care patients with a new diagnosis of depression (N=330) were randomly assigned to 3 months of PS-cCBT or a usual-care control condition. Linear mixed-effects models were used to assess differences in depression symptoms, general mental health status, quality of life, and mental health recovery measured at baseline and 3 and 6 months. Results: In adjusted analyses, participants who received PS-cCBT experienced 1.4 points' (95% confidence interval (CI)=0.3-2.5, p=0.01) greater improvement in depression symptoms on the Quick Inventory of Depression Symptomatology-Self Report at 3 months, compared with the control group, but no significant difference was noted at 6 months. PS-cCBT recipients also had 2.6 points' (95% CI=0.5-4.8, p=0.02) greater improvement in quality of life at 3 months on the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form and greater improvement in recovery on the Recovery Assessment Scale at 3 months (3.6 points; 95% CI=0.9-6.2, p=0.01) and 6 months (4.5 points; 95% CI=1.2-7.7, p=0.01). Conclusions: PS-cCBT is an effective option for improving short-term depression symptoms and longer-term recovery among primary care patients newly diagnosed as having depression.
引用
收藏
页码:256 / 262
页数:7
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