Understanding the potential of digital therapies in implementing the standard of care for depression in Europe

被引:2
|
作者
Courtet, Philippe [1 ]
Amiot, Odile [2 ]
Baca-Garcia, Enrique [3 ,4 ,5 ,6 ,7 ,8 ,9 ]
Bellardita, Lara [10 ]
Cerveri, Giancarlo [11 ]
Clair, Anne-Helene [12 ]
De Leo, Diego [13 ]
Drapier, Dominique [14 ]
Fakra, Eric [15 ,16 ]
Gheysen, Francis [17 ]
Giner, Lucas [18 ]
Gonzalez-Pinto, Ana [19 ]
Gussoni, Gualberto [20 ]
Haffen, Emmanuel [21 ]
Lecardeur, Laurent [22 ]
Mayoral-Cleries, Fermin [23 ]
Mennini, Francesco Saverio [24 ,25 ]
Saiz, Pilar A. [8 ,26 ,27 ]
Vieta, Eduard [28 ]
Hidalgo, Diego Alberto [29 ]
Volpe, Umberto [30 ]
机构
[1] Univ Montpellier, Lapeyronie Hosp, Inst Genomique Fonct, CHU Montpellier,Dept Emergency Psychiat & Acute Ca, Montpellier, France
[2] GH Paul Guiraud, Boulogne Billancourt, France
[3] Univ Hosp Jimenez Diaz Fdn, Dept Psychiat, Madrid, Spain
[4] Univ Hosp Rey Juan Carlos, Dept Psychiat, Mostoles, Spain
[5] Gen Hosp Villalba, Dept Psychiat, Madrid, Spain
[6] Univ Hosp Infanta Elena, Dept Psychiat, Valdemoro, Spain
[7] Madrid Autonomous Univ, Dept Psychiat, Madrid, Spain
[8] Carlos III Inst Hlth, Ctr Invest Salud Mental CIBERSAM, Madrid, Spain
[9] Ctr Hosp Univ Nimes, Dept Psychiat, Nimes, France
[10] Maggiolina & Citta Studi Ctr, Milan, Italy
[11] Addict Hosp, Dept Mental Hlth, Lodi, Italy
[12] Sorbonne Univ, Paris Brain Inst ICM, Inst Cerveau, INSERM,CNRS, Paris, France
[13] Primorska Univ, Dept Psychol, Koper, Slovenia
[14] Pole Hosp Univ Psychiat, Ctr Hosp Guillaume Regnier, CIC Rennes INSERM, Rennes, France
[15] Univ Jean Monnet, St Etienne Univ Hosp, St Etienne, France
[16] Univ Lyon 1, Univ Jean Monnet St Etienne, Ctr Rech Neurosci Lyon CRNL, PsyR2 Team,INSERM U1028,CNRS UMR 5292, St Etienne, France
[17] Compassionate Mind Fdn France, Caen, France
[18] Univ Seville, Dept Psychiat, Seville, Spain
[19] Univ Basque Country, Hosp Univ Alava, Dept Psychiat, BIOARABA,CIBERSAM, Vitoria, Spain
[20] Italian Sci Soc Internal Med FADOI, Clin Res Dept, Milan, Italy
[21] Univ Franche Comte, Serv Psychiat Adulte, UR LINC, CHU Besancon,CIC INSERM 1431, Besancon, France
[22] DueL, Nice, France
[23] Reg Univ Hosp Malaga, Biomed Res Inst Malaga IBIMA, Dept Mental Hlth, Malaga, Spain
[24] Univ Roma Tor Vergata, Fac Econ, DEF Dept, EEHTA CEIS, Rome, Italy
[25] Kingston Univ, Inst Leadership & Management Hlth, London, England
[26] Univ Oviedo, Dept Psychiat, Inst Invest Sanit Principado Asturias ISPA, Oviedo, Spain
[27] Mental Hlth Serv Principal Asturias SESPA, Inst Neurociencias Principado Asturias INEUROPA, Oviedo, Spain
[28] Univ Barcelona, Hosp Clin, Inst Neurosci, IDIBAPS,CIBERSAM, Barcelona, Spain
[29] Univ Barcelona, Hosp Clin, Inst Neurosci, Bipolar Disorders Unit,IDIBAPS,CIBERSAM, Barcelona, Spain
[30] Univ Politecn Marche, Dept Clin Neurosci, Clin Psychiat Unit, Ancona, Italy
关键词
Digital therapeutics; DTx; depression; Deprexis;
D O I
10.1192/j.eurpsy.2023.2453
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Depressive disorders represent the largest proportion of mental illnesses, and by 2030, they are expected to be the first cause of disability-adjusted life years [1]. The COVID-19 pandemic exacerbated prevalence and burden of depression and increased the occurrence of depressive symptoms in general population [2]. The urgency of implementing mental health services to address new barriers to care persuaded clinicians to use telemedicine to follow patients and stay in touch with them, and to explore digital therapeutics (DTx) as potential tools for clinical intervention [2]. The combination of antidepressants and psychotherapy is widely recommended for depression by international guidelines [3] but is less frequently applied in real-world practice. Commonly used treatments are pharmacological, but while being effective, some aspects such as adherence to the drug regimen, residual symptoms, resistance, lack of information, and stigma may hinder successful treatment. In case of less severe depression, standalone psychological therapies should be the first-line treatment option [3], but access to trained psychotherapists remains inequitable. DTx are evidence-based therapies driven by software programs to treat or complement treatment of a specific disease. DTx are classified as Medical Devices, and given their therapeutic purpose, they need to be validated through randomized controlled clinical trials, as for drug-based therapies. In the last 10 years, studies of digital interventions have proliferated; these studies demonstrate that digital interventions increase remission rates and lower the severity of depressive symptoms compared with waitlist, treatment as usual, and attention control conditions [4]. Despite the efficacy demonstrated in clinical trials, many of these tools never reach real-life patients; thus, it might be necessary to implement DTx in the public health system to expand access to valid treatment options. In this framework, DTx represent a good opportunity to help people with depression receive optimal psychotherapeutic care [5].
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页数:3
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