Internet-based cost-effective visualization and stepped care for depression and anxiety

2020 Fiscal Year Final Research Report

• Project/Area Number: 17H04091
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Chiba University
• Principal Investigator: Shimizu Eiji 千葉大学, 大学院医学研究院, 教授 (00292699)
• Co-Investigator(Kenkyū-buntansha): 村松 公美子 新潟青陵大学, 福祉心理学部, 教授 (60339950) ; 吉永 尚紀 宮崎大学, 医学部, 准教授 (80633635)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 認知行動療法 / うつ病 / 不安症 / 不眠症 / 薬物療法 / 医療経済

Outline of Final Research Achievements

Our newly developed patient registration app for depression, anxiety, QOL scale and medical expenses could visualize monthly medical costs of pharmacotherapy and cognitive-behavioral therapy. Our registration site for the medical staff showed improvement of depression and anxiety by cognitive-behavioral therapy. A one-year prognosis study of face-to-face cognitive-behavioral therapy for social anxiety and a one-year prognosis study of online cognitive-behavioral therapy for obsessive-compulsive disorder, social anxiety disorder, and panic disorder showed that it was cost-effective. As a guide to stepped care, we provided 4-week internet cognitive-behavioral therapy to people suffering from insomnia and demonstrated its effectiveness in randomized controlled trials. Approximately half of participants on the online research preferred cognitive-behavioral therapy for insomnia over medication and Internet cognitive-behavioral therapy over face-to-face.

Free Research Field

精神医学

Academic Significance and Societal Importance of the Research Achievements

うつ（PHQ-9)、不安（GAD-7)、QOL（EQ-5D)の尺度スコアと医療費をアプリで収集して、見える化するデータベースを構築していくことは、認知行動療法および薬物療法の医療経済効果を含む科学的根拠に基づいた普及の推進のために有意義であることが示された。また、対面およびオンラインの認知行動療法は費用対効果に優れていることも社会的意義が大きい。うつ病、不安症にまで至らず、不眠のみに症状が留まる場合は、インターネット認知行動療法を提供するStepped Careへ誘導することの重要性が明らかとなった。