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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02864-4

摘要内容如下：

在资源匮乏的环境中，迫切需要可扩展的解决方案来治疗老年人抑郁症。ProDigital-D实用、单盲、双臂、个体随机对照试验评估了移动信息心理社会干预在改善巴西瓜鲁柳斯社会经济贫困地区老年人抑郁症状方面的有效性。老年人（60岁以上）在24个初级保健诊所登记，并被确定为抑郁症状（9项患者健康问卷（PHQ-9）评分≥10），他们接受了基于心理教育和行为激活（n=298）或单一信息（n=305）的为期6周的Viva Vida干预。没有提供卫生专业人员的支持。主要转归是3个月时抑郁症状的改善（PHQ-9<10）。在登记的603名参与者中（平均年龄=65.1岁；451名（74.8%）女性），527名（87.4%）完成了随访评估。在干预组中，257名参与者中有109名（42.4%）的抑郁症状得到改善，而在对照组中，270名参与者中有87名（32.2%）的抑郁症状得到改善（调整后的比值比=1.57；95%置信区间=1.07-2.29；P=0.019）。未观察到与参与试验相关的严重不良事件。这些结果证明了数字信息心理社会干预在短期改善抑郁症状方面的有效性，这可能会被整合到治疗老年抑郁症的初级保健计划中。巴西临床试验注册中心：REBEC（RBR-4C94DTN）。

英文原文如下：

Abstracts

Scalable solutions to treat depression in older adults in low-resourced settings are urgently needed. The PRODIGITAL-D pragmatic, single-blind, two-arm, individually randomized controlled trial assessed the effectiveness of a mobile messaging psychosocial intervention in improving depressive symptomatology among older adults in socioeconomically deprived areas of Guarulhos, Brazil. Older adults (aged 60+ years) registered with 24 primary care clinics and identified with depressive symptomatology (9-item Patient Health Questionnaire (PHQ-9) scores ≥ 10) received the 6-week Viva Vida intervention based on psychoeducation and behavioral activation (n = 298) or a single message (n = 305). No health professional support was offered. The primary outcome was improvement from depressive symptomatology (PHQ-9 < 10) at 3 months. Of the 603 participants enrolled (mean age = 65.1 years; 451 (74.8%) women), 527 (87.4%) completed the follow-up assessment. In the intervention arm, 109 of 257 (42.4%) participants had an improved depressive symptomatology, compared with 87 of 270 (32.2%) participants in the control arm (adjusted odds ratio = 1.57; 95% confidence interval = 1.07-2.29; P = 0.019). No severe adverse events related to trial participation were observed. These results demonstrate the usefulness of a digital messaging psychosocial intervention in the short-term improvement from depressive symptomatology that can potentially be integrated into primary care programs for treating older adults with depression. Brazilian Registry of Clinical Trials registration: ReBEC ( RBR-4c94dtn ).

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