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Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial

Identifieur interne : 000A52 ( Main/Exploration ); précédent : 000A51; suivant : 000A53

Efficacy of Seren@ctif, a Computer-Based Stress Management Program for Patients With Adjustment Disorder With Anxiety: Protocol for a Controlled Trial

Auteurs : Dominique Servant [France] ; Anne-Claire Leterme [France] ; Olivia Barasino [France] ; Laure Rougegrez [France] ; Alain Duhamel [France] ; Guillaume Vaiva [France]

Source :

RBID : Hal:hal-02450519

Abstract

Background: Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports.Objective: The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit.Methods: This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator.Results: The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018.Conclusions: To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress.Trial Registration: Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT026


Url:
DOI: 10.2196/resprot.7976


Affiliations:


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<name sortKey="Duhamel, Alain" sort="Duhamel, Alain" uniqKey="Duhamel A" first="Alain" last="Duhamel">Alain Duhamel</name>
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<idno type="IdRef">191047686</idno>
<idno type="RNSR">199814198W</idno>
<orgName>Santé publique : épidémiologie et qualité des soins-EA 2694</orgName>
<orgName type="acronym">CERIM</orgName>
<desc>
<address>
<addrLine>1, place de Verdun 59045 - Lille cedex</addrLine>
<country key="FR"></country>
</address>
</desc>
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<org type="institution" xml:id="struct-425779" status="VALID">
<orgName>Centre Hospitalier Régional Universitaire [Lille]</orgName>
<orgName type="acronym">CHRU Lille</orgName>
<desc>
<address>
<addrLine>2, avenue Oscar Lambret - 59037 Lille Cedex</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.chru-lille.fr/</ref>
</desc>
</org>
</tutelle>
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<org type="institution" xml:id="struct-374570" status="VALID">
<idno type="IdRef">223446556</idno>
<orgName>Université de Lille</orgName>
<date type="start">2018-01-01</date>
<desc>
<address>
<addrLine>Lille</addrLine>
<country key="FR"></country>
</address>
<ref type="url">https://www.univ-lille.fr/</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>France</country>
</affiliation>
</author>
<author>
<name sortKey="Vaiva, Guillaume" sort="Vaiva, Guillaume" uniqKey="Vaiva G" first="Guillaume" last="Vaiva">Guillaume Vaiva</name>
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<idno type="IdRef">187405425</idno>
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<orgName>Sciences Cognitives et Sciences Affectives (SCALab) - UMR 9193</orgName>
<orgName type="acronym">SCALab</orgName>
<date type="start">2015-01-01</date>
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<orgName>Université de Lille</orgName>
<date type="start">2018-01-01</date>
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<address>
<addrLine>Lille</addrLine>
<country key="FR"></country>
</address>
<ref type="url">https://www.univ-lille.fr/</ref>
</desc>
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<idno type="IdRef">02636817X</idno>
<idno type="ISNI">0000000122597504</idno>
<orgName>Centre National de la Recherche Scientifique</orgName>
<orgName type="acronym">CNRS</orgName>
<date type="start">1939-10-19</date>
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<address>
<country key="FR"></country>
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</hal:affiliation>
<country>France</country>
</affiliation>
</author>
</analytic>
<idno type="DOI">10.2196/resprot.7976</idno>
<series>
<title level="j">JMIR Research Protocols</title>
<idno type="ISSN">1929-0748</idno>
<imprint>
<date type="datePub">2017</date>
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<div type="abstract" xml:lang="en">
<p>Background: Adjustment disorder with anxiety (ADA) is the most frequent and best characterized stress-related psychiatric disorder. The rationale for prescription of benzodiazepine monotherapy is a public health issue. Cognitive behavioral stress management programs have been studied in many countries. Several reports have shown beyond reasonable doubt their efficiency at reducing perceived stress and anxiety symptoms and improving patient quality of life. Considering the number of people who could benefit from such programs but are unable to access them, self-help programs have been offered. First presented as books, these programs became enriched with computer-based and digital supports. Regrettably, programs for stress management based on cognitive behavioral therapy (CBT), both face-to-face and digital support, have been only minimally evaluated in France. To our knowledge, the Seren@ctif program is the first French language self-help program for stress management using digital supports.Objective: The aim of this study is to assess the effectiveness of a 5-week standardized stress management program for reducing anxiety conducted via eLearning (iCBT) or through face-to-face interviews (CBT) with patients suffering from ADA compared with a wait list control group (WLC). These patients seek treatment in a psychiatric unit for anxiety disorders at a university hospital. The primary outcome is change in the State Trait Anxiety Inventory scale trait subscale (STAI-T) between baseline and 2-month visit.Methods: This is a multicenter, prospective, open label, randomized controlled study in 3 parallel groups with balanced randomization (1:1:1): computer-based stress management with minimal contact (not fully automated) (group 1), stress management with face-to-face interviews (group 2), and a WLC group that receives usual health care from a general practitioner (group 3). Programs are based on standard CBT principles and include 5 modules in 5 weekly sessions that include the following topics: stress and stress reaction and assessment; deep respiration and relaxation techniques; cognitive restructuring, mindfulness, and acceptance; behavioral skills as problem solving; and time management, healthy behaviors, and emotion regulation. In the Internet-based group, patients have minimal contact with a medical professional before and after every session. In the first session, a flash memory drive is supplied containing videos, audio files, a self-help book portfolio in the form of an eGuide, and log books providing the exercises to be completed between 2 sessions. The patient is encouraged to practice a 20-minute daily exercise 5 or 6 times per week. In the face-to-face group, patients receive the same program from a therapist with 5 weekly sessions without digital support. Interviews and self-assessments were collected face-to-face with the investigator.Results: The feasibility of this program is being tested, and results show good accessibility in terms of acceptance, understanding, and treatment credibility. Results are expected in 2018.Conclusions: To our knowledge, this is the first French study to examine the effectiveness of a computer-based stress management program for patients with ADA. The Seren@ctif program may be useful within the framework of a psychoeducative approach. It could also be advised for people suffering from other diseases related to stress and for people with a clinical level of perceived stress.Trial Registration: Clinicaltrials.gov NCT02621775; https://clinicaltrials.gov/ct2/show/NCT026</p>
</div>
</front>
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<affiliations>
<list>
<country>
<li>France</li>
</country>
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<tree>
<country name="France">
<noRegion>
<name sortKey="Servant, Dominique" sort="Servant, Dominique" uniqKey="Servant D" first="Dominique" last="Servant">Dominique Servant</name>
</noRegion>
<name sortKey="Barasino, Olivia" sort="Barasino, Olivia" uniqKey="Barasino O" first="Olivia" last="Barasino">Olivia Barasino</name>
<name sortKey="Duhamel, Alain" sort="Duhamel, Alain" uniqKey="Duhamel A" first="Alain" last="Duhamel">Alain Duhamel</name>
<name sortKey="Leterme, Anne Claire" sort="Leterme, Anne Claire" uniqKey="Leterme A" first="Anne-Claire" last="Leterme">Anne-Claire Leterme</name>
<name sortKey="Rougegrez, Laure" sort="Rougegrez, Laure" uniqKey="Rougegrez L" first="Laure" last="Rougegrez">Laure Rougegrez</name>
<name sortKey="Vaiva, Guillaume" sort="Vaiva, Guillaume" uniqKey="Vaiva G" first="Guillaume" last="Vaiva">Guillaume Vaiva</name>
</country>
</tree>
</affiliations>
</record>

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