【双语阅读】新研究发现转向远程医疗后心理治疗的连续性更好

New Research Finds Greater Continuity of Psychotherapy After Shift to Telehealth

新研究发现转向远程医疗后心理治疗的连续性更好

2023年10月11日

Washington, D.C. — The rapid transition to virtual care that occurred with the onset of the COVID-19 pandemic resulted in better continuity of psychotherapy visits compared to prior to the pandemic when almost all visits were in-person, according to new research published in Psychiatric Services, a journal of the American Psychiatric Association.In addition, the time between appointments grew shorter after the transition to virtual care. The study results highlight the benefits of continued availability of virtual psychotherapy. 

华盛顿特区——随着COVID-19疫情的爆发，原本几乎都是面对面进行的心理治疗，快速向通过网络远程治疗的方式过渡，根据发表在美国精神病学协会期刊《精神病服务》上的一项新研究发现，线上远程形式使心理治疗会谈的连续性更好。此外，在转向远程治疗后，两次预约之间的间隔缩短了。该研究结果强调了远程心理治疗持续可约的便捷性带来的益处。 

This large population-level study found that after the onset of the COVID pandemic, when about half of all psychotherapy visits were via telehealth, patients with mental health conditions were less likely to have significant disruption in care—defined as gaps of more than 45 days between psychotherapy appointments. 

这项大规模群体研究发现，在COVID疫情爆发后，约有一半的心理治疗通过远程会谈方式进行，使得有心理健康困扰的来访者在治疗中明显中断的可能性更小——明显中断的定义为两次心理治疗预约间隔超过45天。 

Individuals with mental health conditions often miss health care appointments, and lapses in treatment can hinder overall improvement in mental health symptoms. Efforts to improve engagement in care are essential to promoting overall wellness among those receiving care, the authors note. 

有心理健康困扰的来访者经常错过医保预约，而治疗中断可能阻碍精神健康症状的整体改善效果。作者指出，努力提高治疗的参与度对促进来访者的全面身心健康至关重要。 

The researchers analyzed electronic health records and insurance claims data for more than 110,000 individuals with at least one psychiatric diagnosis who attended at least two psychotherapy visits (for a total of more than 550,000 visits) during the nine months before and nine months after the onset of COVID-19 (June 14, 2019, through Dec. 15, 2020). 

研究人员分析了超过11万名患者的电子健康记录和保险索赔数据，这11万名患者为至少有一种精神疾病诊断、且在疫情爆发前9个月和疫情后9个月（2019年6月14日至2020年12月15日）至少接受过2次心理治疗（总共超过55万次）的人群。

Before the pandemic, 97% of psychotherapy visits were in person and approximately 35% of the visits were followed by a gap of more than 45 days. In the period after the onset of the pandemic, more than half of visits (52%) were virtual, and about 18% of visits were followed by a gap of more than 45 days. In addition, prior to the pandemic, the median time between visits was 27 days and after the pandemic it was 14 days. Thus, individuals were more likely to return for additional psychotherapy after the widespread shift to virtual care. 

在疫情之前，97%的心理治疗会谈是面对面进行的，大约35%的会谈之后再次预约的间隔超过45天。在疫情发生后的一段时间内，一半以上（52%）的会谈是线上虚拟形式，约18%的会谈之后再次预约的间隔超过45天。此外，在疫情之前，两次预约间隔的中位数时间为27天，疫情之后则为14天。因此，在远程治疗形式普遍化后，人们更有可能复约更多的心理治疗。

For all types of psychiatric diagnoses studied, and across sociodemographic characteristics, individuals experienced fewer disruptions in psychotherapy in the nine months after COVID-19 began compared to before. However, the magnitude of the difference in disruption varied across psychiatric diagnoses. Individuals with depressive, anxiety, or bipolar disorders were more likely to maintain consistent psychotherapy visits, whereas those with schizophrenia, ADHD, autism, conduct or disruptive disorders, dementia, or personality disorders were more likely to have a disruption in their visits. 

与COVID-19疫情前相比，在疫情开始后的9个月，研究涉及到的所有类型的精神疾病、以及各类社会人口学特征的个体进行心理治疗的中断情况都更少。 然而，不同精神疾病诊断的治疗中断情况有所差别。患有抑郁症、焦虑症或双相情感障碍的人更有可能坚持持续的心理治疗，而患有精神分裂症、多动症、自闭症、行为障碍或破坏性障碍、痴呆或人格障碍的人更有可能中断治疗。

Overall, the results of the research, the authors conclude, support the continued availability of virtual psychotherapy when appropriate infrastructure is in place. The research team was led by Brian K. Ahmedani, Ph.D., with the Center for Health Policy and Health Services Research, Henry Ford Health, Detroit. The project was supported by the National Institute of Mental Health. 

作者总结道，总的来说，当所需的基础功能到位时，研究结果支持远程心理治疗的持续可用性。该研究小组由底特律亨利福特健康中心卫生政策和卫生服务研究中心的Brian K. Ahmedani博士领导。该项目得到了国家心理健康研究所的支持。 

原文来源：

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,000 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.

美国精神病学协会

美国精神病学协会成立于1844年，是美国历史最悠久的医学协会。美国精神病学协会也是世界上最大的精神病学协会，拥有超过38,000名医生成员，专门从事精神疾病的诊断、治疗、预防和研究。APA的愿景是确保获得高质量的精神病诊断和治疗。欲了解更多信息，请访问www.psychiatry.org。

原文网址：

https://www.psychiatry.org/News-room/News-Releases/Continuity-of-psychotherapy-with-telehealth

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