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

Autor:	Courtet P; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital CHU Montpellier, Institut de Génomique Fonctionnelle, Université de Montpellier, CNRS, INSERM, Montpellier, France., Amiot O; GH Paul Guiraud, Boulogne Billancourt, France., Baca-Garcia E; Department of Psychiatry, University Hospital Jimenez Diaz Foundation, Madrid, Spain.; Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain.; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.; Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.; Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.; Centro de Investigacion en Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain.; Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France., Bellardita L; Maggiolina and Città Studi Center, Milan, Italy., Cerveri G; Department of Mental Health, Addiction Hospital, Lodi, Italy., Clair AH; Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, INSERM, CNRS, Paris, France., De Leo D; Department of Psychology, Primorska University, Koper, Slovenia., Drapier D; Centre Hospitalier Guillaume régnier, Pôle Hospitalo universitaire de psychiatrie, CIC Rennes INSERM, Rennes, France., Fakra E; Saint Étienne University Hospital, University Jean Monnet, Saint Étienne, France.; PsyR2 Team, Centre de Recherche en Neurosciences de Lyon (CRNL), INSERM U1028, CNRS UMR 5292, Université Jean Monnet Saint Etienne, Université Lyon 1, Saint-Étienne, France., Gheysen F; Compassionate Mind Foundation France, Caen, France., Giner L; Department of Psychiatry, Universidad de Sevilla, Seville, Spain., Gonzalez-Pinto A; BIOARABA, Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, CIBERSAM, Vitoria, Spain., Gussoni G; Clinical Research Department, Italian Scientific Society of Internal Medicine (FADOI), Milan, Italy., Haffen E; UR LINC, Service de psychiatrie de l'adulte, CIC-1431 INSERM, CHU de Besançon, Université de Franche-Comté, Besançon, France., Lecardeur L; DueL, Nice, France., Mayoral-Cleries F; Department of Mental Health, Regional University Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain., Mennini FS; EEHTA-CEIS, DEF Department, Faculty of Economic, University of Rome Tor Vergata, Roma, Italy.; Institute for Leadership and Management in Health, Kingston University, London, UK., Sáiz PA; Centro de Investigacion en Salud Mental (CIBERSAM), Carlos III Institute of Health, Madrid, Spain.; Department of Psychiatry, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain.; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain., Vieta E; Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain., Hidalgo DA; Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain., Volpe U; Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, Ancona, Italy.
Jazyk:	angličtina
Zdroj:	European psychiatry : the journal of the Association of European Psychiatrists [Eur Psychiatry] 2023 Oct 24; Vol. 66 (1), pp. e82. Date of Electronic Publication: 2023 Oct 24.
DOI:	10.1192/j.eurpsy.2023.2453
Abstrakt:	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].
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu