杂志文章%@ 2368-7959 %I JMIR出版物%V 8% N 卡塔尔世界杯8强波胆分析12% P e26814 %T一种辅助的基于互联网的干预，以加强成人抑郁症的治疗:随机对照试验%佩雷斯,J卡罗拉%费尔南德斯,奥尔加%卡塞雷斯,克里斯蒂安·卡拉斯科%,阿尔瓦罗·E % Moessner,马库斯%鲍尔,斯蒂芬妮% Espinosa-Duque,丹尼尔% Gloger,塞吉奥% Krause, Mariane % + Facultad de Psicologia大学del Desarrollo Avda拉广场680年拉斯维加斯conde,圣地亚哥,7610658,智利,56 997 051 989 janetperez@udd.cl % K抑郁% K e-mental健康% K混合保健% K互联网% D原始论文7 16.12.2021 % 9 2021% % J JMIR健康% G英语% X的背景:基于互联网的干预措施有望提高更多人和更偏远地区获得精神卫生保健的机会。它们在预防和治疗各种精神障碍方面的有效性已得到证明。然而，它们作为常规治疗的补充(即混合治疗)的潜力尚不清楚。目的:本研究的目的是研究除常规面对面治疗(TAU)外，互联网干预(ASCENSO)对抑郁症的有效性。方法:在智利的一家私立门诊精神卫生保健中心进行了一项2组、平行组、随机对照试验。总共有167名成年人被诊断患有重度抑郁症，没有严重的合并症，并且可以上网。84名参与者被分配到干预组，并接受来自精神卫生中心的医疗和心理TAU，并访问ASCENSO在线平台。对照组(n=83)只接受TAU。 The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results: Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration: ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467 %M 34927594 %R 10.2196/26814 %U https://mental.www.mybigtv.com/2021/12/e26814 %U https://doi.org/10.2196/26814 %U http://www.ncbi.nlm.nih.gov/pubmed/34927594