Eficacia de una intervención psicológica breve basada en mindfulness para el tratamiento de la depresión en atención primaria: aplicación cara a cara, aplicación mediante TICs versus tratamiento habitualdissertation
Аннотация: According to the World Health Organization, depression is one of the main causes of disability worldwide. In Spanish Primary Care (PC) services, there has been a significant increase in mental disorders, being mood disorders the most increased by 19-20%. Despite this, the pharmacological prescription is the quintessential treatment even with the high relapse rates which increase with each episode. Lack of time and resources make it difficult to dispense evidence-based treatments. For this reason, research has focused, on the one hand, on low-intensity interventions and, on the other, on interventions applied through Information and Communication Technologies. Both ways of applying psychological treatments have shown efficacy in depression treatment. However, few studies have used third-generation therapies, such as mindfulness, to reduce depression symptoms in Primary Care settings, despite the studies that support the efficacy of these techniques. The objective of this thesis was to compare a low intensity mindfulness intervention for the treatment of depression in PC, on the one hand, applied face to face and, on the other, self-applied, compared to a control group receiving medical treatment as usual. A randomized controlled clinical trial with three experimental conditions is presented. Participants were patients with mild-moderate depression recruited from PC settings by their GPs. The patients who met the inclusion and exclusion criteria were randomized to one of three conditions: face-to-face + TAU, + TAU, and alone. The primary outcome measure was depressive symptoms measured with Beck's depression inventory. Secondary measures were affectivity, quality of life, happiness, and mindfulness. These measurements were collected at three different times, at pre-treatment, post-treatment and at 6 months follow-up after the intervention. Of the 182 participants evaluated, 130 met the inclusion criteria and were randomized. Specifically, 45 participants were assigned to the face-to-face + group, 44 were assigned to the + MBI online group and 41 to the alone group. The results showed statistically significant differences between groups in the measure of depression. MBI (both face-to-face and online) were more effective than TAU with large effect sizes. Furthermore, these differences were maintained at 6-month follow-up. In the secondary measures, only significant changes were observed in negative affect, mental health and the happiness index, in the MBI groups. Furthermore, MBI (both face-to-face and online) were rated as more satisfactory than TAU. However, no differences were observed between the two MBI groups. In conclusion, the mindfulness-based intervention was shown to be effective for the treatment of mild-moderate depression in PC settings, both in the short and medium term and applied in both formats (face-to-face and online). Therefore, MBI appears to be a promising tool to deal with PC problems such as lack of time and cost issues.
Год издания: 2020
Авторы: Alba López Montoyo
Ключевые слова: Digital Mental Health Interventions, Mindfulness and Compassion Interventions, Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
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