A randomised control trial of an Internet-based cognitive behaviour treatment for mood disorder in adults with chronic spinal cord injury

作者：Migliorini C^*; Sinclair A; Brown D; Tonge B; New P

来源：Spinal Cord, 2016, 54(9): 695-701.

DOI：10.1038/sc.2015.221

Study design: Prospective parallel waitlist randomised controlled trial.
Objectives: Evaluate the feasibility and effectiveness of an Internet-based psychological intervention treating comorbid mood disorder in adults with spinal cord injury (SCI). Improved mood and satisfaction with life were primary outcomes.
Setting: Victoria, Australia.
Intervention: Electronic Personal Administration of Cognitive Therapy (ePACT).
Measures: Depression, Anxiety and Stress Scale-Short Form (DASS21), Personal Well-being Index, Helplessness subscale of the Spinal Cord Lesion Emotional Well-being Scale v1 Australia, at each time point.
Participant qualifying criteria: Adults (18-70 years), chronic SCI, attend SCI review clinic at Austin or Caulfield Hospital and score above normative threshold of the Depression, Anxiety and Stress Scale-Short Form (DASS21).
Methods: Forty-eight participants completed Time 2 post intervention (n = 23) or time equivalent for waitlist control group (n = 25) telephone interviews. The measures were repeated a third time (Time 3) for a small subgroup (n = 12) at 6 months post intervention within the study implementation time frame.
Results: Univariate within group analyses revealed significant improvement in mood in the intervention group at Time 2: (lower depression (effect size (ES) = 0.4), anxiety (ES = 0.4) and stress (ES = 0.3)) and higher satisfaction with life (ES = 0.2). Waitlist control group improved in depression only (ES = 0.3) by Time 2. Multilevel variance components analyses, although not as positive, were still encouraging. Improvement in mood symptoms was maintained in the small group reinterviewed at Time 3.
Conclusion: Although Internet-based interventions for mental health issues in SCI not a solution for all, our results indicate that they are a potentially valuable addition to the currently available options.

• 出版日期2016