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Trajectories of depression symptoms, anxiety symptoms and functional impairment during internet-enabled cognitive-behavioural therapy.
Skelton, Megan; Catarino, Ana; Brown, Stephanie; Carr, Ewan; Davies, Molly R; Peel, Alicia J; Rayner, Christopher; Breen, Gerome; Eley, Thalia C.
Afiliación
  • Skelton M; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
  • Catarino A; Digital Futures Lab, ieso, Cowley Road, The Jeffreys Building, Milton, Cambridge, UK.
  • Brown S; Digital Futures Lab, ieso, Cowley Road, The Jeffreys Building, Milton, Cambridge, UK.
  • Carr E; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Davies MR; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Peel AJ; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Rayner C; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Breen G; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
  • Eley TC; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: thalia.eley@kcl.ac.uk.
Behav Res Ther ; 169: 104386, 2023 10.
Article en En | MEDLINE | ID: mdl-37634279
Underlying classes capture differences between patient symptom trajectories during psychological therapy. This has not been explored for one-to-one internet-delivered therapy or functional impairment trajectories. Patients experiencing depression or anxiety received cognitive-behavioural therapy with a therapist using an online chat platform (N = 52,029). Trajectory classes of depression symptoms (PHQ9), anxiety symptoms (GAD7) and functional impairment (WSAS) were investigated using growth mixture modelling. Multinomial regressions tested associations between baseline variables and trajectory class. A four-class trajectory model was selected for each outcome, and these were highly similar. Each outcome showed three classes with initially moderate-severe symptoms or impairment: one demonstrated no change, one gradual improvement and one fast improvement. A fourth class had mild baseline scores and minimal improvement. In the moderate-severe classes, patients in the two with improvement were more likely to be employed and not to have obsessive-compulsive disorder. Fast improvement was likelier than gradual improvement or no change for patients with older age, no disability (e.g., physical, learning), or lower comorbid symptom or impairment scores. Associations with functional impairment classes were more similar to associations with depression classes than anxiety classes. Results were largely consistent with findings from face-to-face therapy. This study is an important step towards personalising therapy in terms of suitability and continuation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Cognitivo-Conductual / Trastorno Obsesivo Compulsivo Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Behav Res Ther Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia Cognitivo-Conductual / Trastorno Obsesivo Compulsivo Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Behav Res Ther Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido