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Internet-based Cognitive Behavior Therapy for Stress Disorders: a Randomized Trial

13. december 2019 opdateret af: Erik Hedman, Karolinska Institutet
Stress disorders in form of adjustment disorder and burnout syndrom are highly prevalent and cause substantial suffering. Prior evidence suggest that these disorders may be effectively treated with cognitive behavior therapy (CBT), but access to psychological treatment is limited. One possible solution is to provide therapy via the Internet, which has been shown to be effective for anxiety disorders and depression. In the present study, we will investigate the efficacy of Internet-based CBT (ICBT) for adjustment disorders and burnout syndrom in a randomized controlled trial (N=100). Participants will be randomized to active treatment (n=50) or a control condition on waiting list.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Stress disorders in form of adjustment disorder and burnout syndrom are highly prevalent and cause substantial suffering. Prior evidence suggest that these disorders may be effectively treated with cognitive behavior therapy (CBT), but access to psychological treatment is limited. One possible solution is to provide therapy via the Internet, which has been shown to be effective for anxiety disorders and depression. Internet-based CBT can be described as online bibliotherapy with therapist support via a secure messaging system. In this study psychologists will deliver the treatment. We will investigate the efficacy of Internet-based CBT (ICBT) for adjustment disorder and burnout syndrom in a randomized controlled trial (N=100). Participants will be randomized to active treatment (n=50) or a control condition on waiting list. We expect that participants who receive ICBT will make superior improvements compared to the control condition on measures of stress, burnout, depressive symptoms, general anxiety and general functioning.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

100

Fase

  • Ikke anvendelig

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

To be included in the study participants must be between 18 and 65 years of age and suffer from primary stress-related disorders by meeting diagnostic criteria for adjustment disorder or burnout syndrome. Participants must have access to a computer and to the Internet, as well as being able to write and write in Swedish.

Exclusion Criteria:

Exclusion criteria include (a) meeting the criteria for another axis-1 diagnosis that is assessed to be the primary area of difficulty, (b) suffering from substance abuse/dependence in the past 6 months, (c) suffering from current or past psychosis or bipolar disorder, (d) moderate to high suicide risk, (e) initiated or changed pharmachological treatment for depression or anxiety in the past month and (f) other on-going psychological treatment for stress-related difficulties, and (g) not having received CBT for stress-related ill-health in the past year.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Active treatment, Internet-based CBT
Internet-based treatment with therapist support using an asynchronous messaging system. The treatment is comprised of 12 modules (similar to chapters) and the treatment is 12 weeks long. The treatment is based on cognitive behavior therapy. Participants will be stratified based on diagnosis, i.e. adjustment disorder and burnout.
Adfærdsmæssigt: Internet-based CBT
Internet-based treatment with therapist support using an asynchronous messaging system. The treatment is comprised of 12 modules (similar to chapters) and the treatment is 12 weeks long. The treatment is based on cognitive behavior therapy
Ingen indgriben: Waiting list control
The control condition is a waiting list. Participants in this arm receive no active treatment. After 12 weeks on waiting list, participants are crossed over to treatment.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Perceived stress scale (PSS)
Tidsramme: baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Change in PSS at post-treatment and follow-up compared to baseline
baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Shirlom Melamed Burnout Questionnaire (SMBQ)
Tidsramme: baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Change in SMBQ at post-treatment and follow-up compared to baseline
baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Insomnia Severity Index (IS)
Tidsramme: baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Change in ISI at post-treatment and follow-up compared to baseline
baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Generalized AnxietyDisorder-7 (GAD-7)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in GAD-7 at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Physical Health Questionnaire-15 (PHQ-15)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in PHQ-15 at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Montgomery Åsberg Depression Rating Scale - self-rated (MADRS-S)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in MADRS-S at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Self-rated health (SRH)
Tidsramme: baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Change in SRH at post-treatment and follow-up compared to baseline
baseline, weekly during treatment, post-treatment (12 weeks), 6 month follow-up
Work Ability Index (WAI)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in WAI at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Euroqol 5 dimensions (EQ5D)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in EQ5D at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Brunnsviken Brief Quality of life inventory (BBQ)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in BBQ at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
World Health Organization Disability Assessment Schedule (WHODAS)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in WHODAS at post-treatment and follow-up compared to baseline.
baseline, post-treatment (12 weeks), 6 month follow-up
Alcohol Disorders Identification Test (AUDIT)
Tidsramme: Baseline
This instrument will be used for screening purpose only
Baseline
Sickness questionnaire state (SQ)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in SQ at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Trimbos and Institute of Technology Cost Questionnaire for Psychiatry (TIC-P) Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry (TIC-P)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in TIC-P at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Karolinska Sleep Questionnaire (KSQ)
Tidsramme: baseline, post-treatment (12 weeks), 6 month follow-up
Change in KSQ at post-treatment and follow-up compared to baseline
baseline, post-treatment (12 weeks), 6 month follow-up
Client Satisfaction Questionnaire (CSQ)
Tidsramme: Post-treatment (12 weeks)
Mean and standard deviations will be presented
Post-treatment (12 weeks)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Credibility Scale (C-scale)
Tidsramme: Week 2 and week 8
Measures treatment credibility. Mean scores and standard deviations will be presented
Week 2 and week 8
Change in Putative mediators
Tidsramme: week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12
week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Karolinska Institutet

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. oktober 2015

Primær færdiggørelse (Faktiske)

1. oktober 2017

Studieafslutning (Faktiske)

1. oktober 2017

Datoer for studieregistrering

Først indsendt

1. september 2015

Først indsendt, der opfyldte QC-kriterier

2. september 2015

Først opslået (Skøn)

3. september 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

16. december 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

13. december 2019

Sidst verificeret

1. december 2019

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • ICBT for stress

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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