Internet-based Cognitive Behavior Therapy for Stress Disorders: a Randomized Trial
13 december 2019 bijgewerkt door: 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.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
100
Fase
- Niet toepasbaar
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 65 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
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.
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: 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.
|
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
|
|
Geen tussenkomst: 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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in Perceived stress scale (PSS)
Tijdsspanne: 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
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Shirlom Melamed Burnout Questionnaire (SMBQ)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: Baseline
|
This instrument will be used for screening purpose only
|
Baseline
|
|
Sickness questionnaire state (SQ)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: Post-treatment (12 weeks)
|
Mean and standard deviations will be presented
|
Post-treatment (12 weeks)
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Credibility Scale (C-scale)
Tijdsspanne: 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
Tijdsspanne: 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
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Lindsater E, Axelsson E, Salomonsson S, Santoft F, Ljotsson B, Akerstedt T, Lekander M, Hedman-Lagerlof E. Cost-Effectiveness of Therapist-Guided Internet-Based Cognitive Behavioral Therapy for Stress-Related Disorders: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res. 2019 Sep 13;21(9):e14675. doi: 10.2196/14675.
- Lindsater E, Axelsson E, Salomonsson S, Santoft F, Ejeby K, Ljotsson B, Akerstedt T, Lekander M, Hedman-Lagerlof E. Internet-Based Cognitive Behavioral Therapy for Chronic Stress: A Randomized Controlled Trial. Psychother Psychosom. 2018;87(5):296-305. doi: 10.1159/000490742. Epub 2018 Jul 24.
- Axelsson E, Lindsater E, Ljotsson B, Andersson E, Hedman-Lagerlof E. The 12-item Self-Report World Health Organization Disability Assessment Schedule (WHODAS) 2.0 Administered Via the Internet to Individuals With Anxiety and Stress Disorders: A Psychometric Investigation Based on Data From Two Clinical Trials. JMIR Ment Health. 2017 Dec 8;4(4):e58. doi: 10.2196/mental.7497.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 oktober 2015
Primaire voltooiing (Werkelijk)
1 oktober 2017
Studie voltooiing (Werkelijk)
1 oktober 2017
Studieregistratiedata
Eerst ingediend
1 september 2015
Eerst ingediend dat voldeed aan de QC-criteria
2 september 2015
Eerst geplaatst (Schatting)
3 september 2015
Updates van studierecords
Laatste update geplaatst (Werkelijk)
16 december 2019
Laatste update ingediend die voldeed aan QC-criteria
13 december 2019
Laatst geverifieerd
1 december 2019
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- ICBT for stress
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .