Предсказатели клинической реакции на когнитивное поведенческое вмешательство с использованием Интернета для выявления симптомов депрессии, беспокойства и инвалидности у людей с множественным склерозом.
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Gandy Milena, Wu Wendy, Dear Blake F
Аннотация
Оригинал публикации
Predictors of clinical response to an internet-delivered cognitive behavioural based intervention for symptoms of depression, anxiety and disability in people with multiple sclerosis.
INTRODUCTION: This study sought to identify demographic, clinical, or psychological factors associated with response to an internet-delivered psychological intervention for depression, anxiety, and disability among adults with Multiple Sclerosis (MS). Identifying these characteristics can help inform psychotherapy referral decisions.
METHOD: Data from participants with a diagnosis of MS (n = 222) were pooled across three clinical trials of an established internet-delivered intervention for people with neurological conditions, including MS. Baseline demographic (age, sex, employment, education, relationship status), clinical (MS type, cognitive difficulties, current psychotropic medication use, previous psychological treatment) and psychological characteristics (baseline symptom severity) were examined. Outcomes included a clinically meaningful response (≥25 % improvement in symptoms) in self-reported symptoms of depression, anxiety, and disability following the intervention. Multivariable logistic regression models were built to identify significant predictors of response. Area under the curve and Negelkerke's R2 are reported.
RESULTS: No robust or consistent factors were associated with the likelihood of a clinically meaningful response across these primary outcomes. Only a few factors predicted a single outcome: baseline depression symptom severity predicted greater odds of a clinical response in depression, age predicted greater odds of response in anxiety, and MS subtype predicted greater odds of response in disability. Current use of psychotropic medication was the only factor that predicted more than one outcome, specifically depression and disability.
CONCLUSION: Findings highlight the limited predictive value of baseline characteristics, suggesting that referral to internet-delivered psychological interventions for adults with MS should not rely solely on simple demographic or clinical profiles.