Zusammenfassung
Anliegen Systematischer Überblick zur
Wirksamkeit von computergestützter kognitiver Verhaltenstherapie bei
depressiven Erkrankungen. Methode Literaturrecherche in
Medline, Web of Science, Cochrane und PsycINFO. Ergebnisse 16 Studien wurden identifiziert. Effekte der
Interventionen sind abhängig von der Häufigkeit und Dauer des
Therapeutenkontaktes und der Art der Kontrollgruppe. Die Effektstärken
erstrecken sich von Cohens d = 0,0 bis
d = 1,1. Schlussfolgerungen
Computergestützte Verhaltenstherapie stellt eine niedrigschwellige
Interventionsmethode dar, die vor allem bei Patienten mit leichter und
mittelschwerer depressiver Symptomatik wirksam ist. In unterversorgten Gebieten
kann sie zur Versorgungsoptimierung beitragen und Baustein eines gestuften
Behandlungsplanes („stepped care”) sein.
Abstract
Objective The aim of this study was to
conduct a systematic literature search in order to assess effectiveness of
computer- and internet-based cognitive behavioural therapy (CCBT).
Methods Medline, Cochrane Library, Web of Science and
PsycINFO were searched for relevant articles. Only RCTs were included. Effect
sizes were calculated and quality of studies was assessed. Results 16 studies were retrieved and included. Effect sizes
depended on therapist time involvement and control group intervention (waiting
list vs. active control group) and ranged between 0.0 and 1.1.
Conclusions CCBT provides an effective and potentially
cost-effective interventional strategy for depressive disorders. Effects of no
and minimal contact therapies are confounded with conditions of control groups
and need further investigation. While patients with Major Depression seem to
benefit from computer-based therapy with regular therapist contact, it remains
unclear whether unattended self-help interventions over the internet are
effective for this patient population. However, these interventions are
effective in patients with mild to moderate depressive symptomatology. CCBT may
serve as a first step of treatment within stepped care approaches and may help
to offer treatment to individuals in remote areas and to decrease barriers to
seek psychiatric care caused by stigma perception.
Schlüsselwörter
kognitive Verhaltenstherapie - computergestützte Therapie - Depressionen
Keywords
cognitive behavioural therapy - computer-assisted therapy - depression
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1 Zwecks besserer Lesbarkeit werden folgend ausschließlich die
männlichen Formen zur Beschreibung von Personen- und Berufsgruppen,
bestehend aus Vertretern beider Geschlechter, verwendet.
2 d = μIG − μKG / √(σ1 + σ2) / 2
3 Spek et al. (2007, 2008) sind Publikationen derselben Studie,
werden hier daher nur einfach gezählt. Gleiches gilt für de Graaf et
al. (2009) und Gerhards et al. (2010).
Dipl.-Psych. Claudia Sikorski
Universität Leipzig, Institut für Sozialmedizin,
Arbeitsmedizin und Public Health
Philipp-Rosenthal-Straße 55
04103 Leipzig
eMail: Claudia.Sikorski@medizin.uni-leipzig.de