抑郁症的计算机化认知行为治疗

Computerized Cognitive Behavioral Therapy for Depression

计算机化认知行为治疗(computerized cognitive-behavioral therapy,CCBT),即指通过电脑交互界面,以清晰的操作步骤,高度结构化的多种媒介互动方式(如网页、漫画、动画、视频、声音等)来表现认知行为治疗基本原则和方法的治疗方式。抑郁症的CCBT近年来在西方崭露头角,目前Beating The Blues、MoodGYM、E-Couch和Good Days Ahead等抑郁症CCBT程序在西方使用较为广泛。从可行性分析上发现,该疗法较受病人接纳、具有较高的成本效用和易用性;现有实验研究证明了抑郁症采用CCBT是有效的,但其有效性仍取决于诸多因素。以往研究存在着较少关注治疗有效性的内在机制、治疗效果差异较大、风险评估简化和被试选择偏向等问题,建议未来研究应加强:(1)中介效应及机制研究;(2)以人为本的个性化服务研究;(3)风险评估与隐私保护研究;(4)在"弱势群体"中的研究与运用。最后,对其在中国发展的必要性与可行性进行了展望。

In Computerized Cognitive Behavioral Therapy （CCBT）,those basic principles and methods commonly used in traditional Cognitive Behavioral Therapy are embodied through computer interface,clear instructions to operation,and highly structured multi-media （e.g.webpage,cartoon,animation,video,audio etc.）.The application of CCBT to depression emerged recently,and some CCBT programs （e.g.Beating The Blues、MoodGYM、E-Couch,and Good Days Ahead） have been popularly applied to the treatment of depression.Eligibility analysis found that CCBT was able to be accepted by patients,high-cost and easy for usage.The effectiveness of CCBT has been evidenced by existing studies,yet relies on a number of factors.The limitations of existing studies involve insufficient attention to the mechanism of effectiveness,significant difference in therapeutic effect among different studies,simplistic risk evaluation,and bias in subject selection.The issues should be emphasized in future studies are （1） mediation effect and mechanism;（2） human-centered individualized services,（3） risk evaluation and privacy protection;（4） focusing on social vulnerable groups.At last,the necessity and eligibility of the development of CCBT in China was discussed.