网络认知行为疗法在抑郁症人群中的应用进展
Recent Progress in Internet-Based Cognitive Behavioral Therapy for Depression
DOI: 10.12677/ap.2025.1512662, PDF,   
作者: 孙玉玺：重庆师范大学应用心理学重点实验室，重庆
关键词: 网络认知行为疗法；抑郁症；综述；Internet-Based Cognitive Behavioral Therapy； Depression； Review
摘要: 抑郁症作为全球高发的精神障碍，其治疗方式不断发展。近年来，网络认知行为疗法(Internet-based Cognitive Behavioral Therapy, ICBT)因其便利性和灵活性而受到关注。本文综述了常用ICBT程序的应用特征，总结了ICBT在青少年、成人及老年抑郁症人群中的应用进展，并分析了ICBT研究中存在的机制不明、个体差异忽视、安全性评估不足等问题。最后，对未来ICBT的整合应用、个性化干预及风险管理提出展望。
Abstract: Depression is a highly prevalent mental disorder worldwide, and its treatment approaches have been continuously evolving. In recent years, Internet-based Cognitive Behavioral Therapy (ICBT) has attracted increasing attention due to its convenience and flexibility. This review summarizes the application features of commonly used ICBT programs and outlines the progress of ICBT interventions among adolescents, adults, and older adults with depression. Furthermore, it analyzes existing challenges in current ICBT research, including unclear mechanisms of action, neglect of individual differences, and insufficient safety assessment. Finally, this paper discusses future directions for ICBT, focusing on integrated application, personalized intervention, and enhanced risk management.
文章引用：孙玉玺 (2025). 网络认知行为疗法在抑郁症人群中的应用进展. 心理学进展, 15(12), 352-358. https://doi.org/10.12677/ap.2025.1512662

参考文献

[1] 崔倩, 张雨, 邹海欧(2021). 网络认知行为疗法在抑郁症患者中的应用. 国际精神病学杂志, 48(1), 10-12.
[2] 李江英, 王秋晨, 王立春(2022). 网络认知行为疗法在抑郁症患者中的应用和研究进展. 心理月刊, 17(13), 235-237.
[3] 李金阳, 张宁, 张斌, 王振, 王纯(2018). 网络版计算机化的认知行为治疗在中国人群的应用及有效性. 中华行为医学与脑科学杂志, 27(2), 115-120.
[4] 任志洪, 黎冬萍, 江光荣(2011). 抑郁症的计算机化认知行为治疗. 心理科学进展, 19(4), 545-555.
[5] 王刚, 胡昌清, 丰雷, 肖乐(2015). 中国抑郁障碍的研究现状与展望. 中华精神科杂志, 48(2), 136-140.
[6] 肖佳维, 相丹, 刘忠纯(2019). 抑郁症与阿片受体及其表观遗传调控. 神经损伤与功能重建, 14(5), 307-309.
[7] 杨文登, 叶浩生(2008). 循证心理治疗述评与展望. 中国循证医学杂志, (11), 951-955.
[8] 尹可丽, 秦旻, 黄希庭(2009). 心理治疗的循证实践与循效施治. 心理科学进展, 17(6), 1327-1335.
[9] Anderson, R., Wong, N., Newby, J. M., & Andrews, G. (2016). The Non-Medical Out-of-Pocket Costs to Attend a Free Anxiety Disorders Treatment Clinic in Australia. Australasian Psychiatry, 24, 261-263.[CrossRef] [PubMed]
[10] Andersson, G. (2016). Internet-Delivered Psychological Treatments. Annual Review of Clinical Psychology, 12, 157-179.[CrossRef] [PubMed]
[11] Berg, M., Andersson, G., & Rozental, A. (2020). Knowledge about Treatment, Anxiety, and Depression in Association with Internet-Based Cognitive Behavioral Therapy for Adolescents: Development and Initial Evaluation of a New Test. Sage Open, 10.[CrossRef] 
[12] Braund, T. A., Tillman, G., Palmer, D. M., Gordon, E., Rush, A. J., & Harris, A. W. F. (2021). Antidepressant Side Effects and Their Impact on Treatment Outcome in People with Major Depressive Disorder: An iSPOT-D Report. Translational Psychiatry, 11, Article No. 417.[CrossRef] [PubMed]
[13] Calear, A. L., Christensen, H., Mackinnon, A., Griffiths, K. M., & O’Kearney, R. (2009). The YouthMood Project: A Cluster Randomized Controlled Trial of an Online Cognitive Behavioral Program with Adolescents. Journal of Consulting and Clinical Psychology, 77, 1021-1032.[CrossRef] [PubMed]
[14] Christ, C., Schouten, M. J., Blankers, M., van Schaik, D. J., Beekman, A. T., Wisman, M. A. et al. (2020). Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Adolescents and Young Adults: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 22, e17831.[CrossRef] [PubMed]
[15] Christensen, H., Griffiths, K. M., & Jorm, A. F. (2004). Delivering Interventions for Depression by Using the Internet: Randomised Controlled Trial. BMJ, 328, 265.[CrossRef] [PubMed]
[16] Crabb, R. M., Cavanagh, K., Proudfoot, J., Learmonth, D., Rafie, S., & Weingardt, K. R. (2012). Is Computerized Cognitive‐Behavioural Therapy a Treatment Option for Depression in Late‐Life? A Systematic Review. British Journal of Clinical Psychology, 51, 459-464.[CrossRef] [PubMed]
[17] Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with Other Treatments. The Canadian Journal of Psychiatry, 58, 376-385.[CrossRef] [PubMed]
[18] Furukawa, T. A., Karyotaki, E., Suganuma, A., Pompoli, A., Ostinelli, E. G., Cipriani, A. et al. (2018). Dismantling, Personalising and Optimising Internet Cognitive-Behavioural Therapy for Depression: A Study Protocol for Individual Participant Data Component Network Meta-Analysis. BMJ Open, 8, e026137.[CrossRef] [PubMed]
[19] Gupta, S. K., Slaven, J. E., Liu, Z., Polanka, B. M., Freiberg, M. S., & Stewart, J. C. (2020). Effects of Internet Cognitive-Behavioral Therapy on Depressive Symptoms and Surrogates of Cardiovascular Risk in Human Immunodeficiency Virus: A Pilot, Randomized, Controlled Trial. Open Forum Infectious Diseases, 7, ofaa280.[CrossRef] [PubMed]
[20] Kaltenthaler, E., Sutcliffe, P., Parry, G., Beverley, C., Rees, A., & Ferriter, M. (2008). The Acceptability to Patients of Computerized Cognitive Behaviour Therapy for Depression: A Systematic Review. Psychological Medicine, 38, 1521-1530.[CrossRef] [PubMed]
[21] Karyotaki, E., Efthimiou, O., Miguel, C., Maas genannt Bermpohl, F., Furukawa, T. A., Cuijpers, P. et al. (2021). Internet-based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-Analysis. JAMA Psychiatry, 78, 361-371.[CrossRef] [PubMed]
[22] Karyotaki, E., Furukawa, T. A., Efthimiou, O., Riper, H., & Cuijpers, P. (2019). Guided or Self-Guided Internet-Based Cognitive-Behavioural Therapy (iCBT) for Depression? Study Protocol of an Individual Participant Data Network Meta-Analysis. BMJ Open, 9, e026820.[CrossRef] [PubMed]
[23] Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S. et al. (2009). Therapist-Delivered Internet Psychotherapy for Depression in Primary Care: A Randomised Controlled Trial. The Lancet, 374, 628-634.[CrossRef] [PubMed]
[24] Khalid, A., Haqqani, S., & Williams, C. (2022). Guided Self-Help Urdu Version of the Living Life to the Full Intervention for Secondary School Adolescents with Low Mood and Anxiety in Pakistan: A Feasibility Study. Heliyon, 8, e09809.[CrossRef] [PubMed]
[25] Letvak, S., Ruhm, C. J., & McCoy, T. (2012). Depression in Hospital-Employed Nurses. Clinical Nurse Specialist, 26, 177-182.[CrossRef] [PubMed]
[26] Linardon, J., Messer, M., Reid, R., Bolger, T., & Andersson, G. (2025). Absolute and Relative Rates of Treatment Non-Initiation, Dropout, and Attrition in Internet-Based and Face-to-Face Cognitive-Behavioral Therapy: A Meta-Analysis of Randomized Controlled Trials. Cognitive Behaviour Therapy, 1-14.[CrossRef] [PubMed]
[27] Månsson, K. N. T., Carlbring, P., Frick, A., Engman, J., Olsson, C., Bodlund, O. et al. (2013). Altered Neural Correlates of Affective Processing after Internet-Delivered Cognitive Behavior Therapy for Social Anxiety Disorder. Psychiatry Research: Neuroimaging, 214, 229-237.[CrossRef] [PubMed]
[28] Pachankis, J. E., Soulliard, Z. A., Layland, E. K., Behari, K., Seager van Dyk, I., Eisenstadt, B. E. et al. (2023). Behaviour Research and Therapy, 169, Article ID: 104403.[CrossRef] 
[29] Pan, J., & Rafi, J. (2025). Culturally Adapted Guided Internet-Based Cognitive Behavioral Therapy for Hong Kong People with Depressive Symptoms: Randomized Controlled Trial. Journal of Medical Internet Research, 27, e64303.[CrossRef] [PubMed]
[30] Perini, S., Titov, N., & Andrews, G. (2009). Clinician-Assisted Internet-Based Treatment Is Effective for Depression: Randomized Controlled Trial. Australian & New Zealand Journal of Psychiatry, 43, 571-578.[CrossRef] [PubMed]
[31] Petrozzi, M. J., Leaver, A., Ferreira, P. H., Rubinstein, S. M., Jones, M. K., & Mackey, M. G. (2019). Addition of MoodGYM to Physical Treatments for Chronic Low Back Pain: A Randomized Controlled Trial. Chiropractic & Manual Therapies, 27, Article No. 54.[CrossRef] [PubMed]
[32] Powell, J., Atherton, H., Williams, V., Martin, A., Bennett, K., Bennett, A. et al. (2017). Effectiveness and Cost-Effectiveness of a Fully Self-Guided Internet-Based Intervention for Sub-Clinical Social Anxiety Symptoms: Protocol for a Randomised Controlled Trial. Digital Health, 3.[CrossRef] [PubMed]
[33] Qaseem, A., Owens, D. K., Etxeandia-Ikobaltzeta, I., Tufte, J., Cross, J. T., & Wilt, T. J. (2023). Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder: A Living Clinical Guideline from the American College of Physicians. Annals of Internal Medicine, 176, 239-252.[CrossRef] [PubMed]
[34] Rost, T., Stein, J., Löbner, M., Kersting, A., Luck-Sikorski, C., & Riedel-Heller, S. G. (2017). User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review. Journal of Medical Internet Research, 19, e309.[CrossRef] [PubMed]
[35] Spek, V., Nyklíček, I., Smits, N., Cuijpers, P., Riper, H., Keyzer, J. et al. (2007). Internet-Based Cognitive Behavioural Therapy for Subthreshold Depression in People over 50 Years Old: A Randomized Controlled Clinical Trial. Psychological Medicine, 37, 1797-1806.[CrossRef] [PubMed]
[36] Titov, N., Dear, B. F., Ali, S., Zou, J. B., Lorian, C. N., Johnston, L. et al. (2015). Clinical and Cost-Effectiveness of Therapist-Guided Internet-Delivered Cognitive Behavior Therapy for Older Adults with Symptoms of Depression: A Randomized Controlled Trial. Behavior Therapy, 46, 193-205.[CrossRef] [PubMed]
[37] Tomasino, K. N., Lattie, E. G., Ho, J., Palac, H. L., Kaiser, S. M., & Mohr, D. C. (2017). Harnessing Peer Support in an Online Intervention for Older Adults with Depression. The American Journal of Geriatric Psychiatry, 25, 1109-1119.[CrossRef] [PubMed]
[38] Waller, R., & Gilbody, S. (2009). Barriers to the Uptake of Computerized Cognitive Behavioural Therapy: A Systematic Review of the Quantitative and Qualitative Evidence. Psychological Medicine, 39, 705-712.[CrossRef] [PubMed]
[39] Xiang, X., Wu, S., Zuverink, A., Tomasino, K. N., An, R., & Himle, J. A. (2020). Internet-Delivered Cognitive Behavioral Therapies for Late-Life Depressive Symptoms: A Systematic Review and Meta-Analysis. Aging & Mental Health, 24, 1196-1206.[CrossRef] [PubMed]
[40] Yu, W., Ying, Y., Wang, L., Yang, Y., Zhang, L., Wang, Y. et al. (2025). Short-Term Alterations of Brain Network Properties in Subthreshold Depression: The Impact of Internet-Based Cognitive Behavioral Therapy. Frontiers in Neurology, 16, Article ID: 1474339.[CrossRef] [PubMed]
[41] Zhang, C., Yang, X., Wan, D., Ma, Q., Yin, P., Zhou, M. et al. (2025). Burden of Neurological Disorders in China and Its Provinces, 1990-2021: Findings from the Global Burden of Disease Study 2021. Med, 6, Article ID: 100692.[CrossRef] [PubMed]