Application Of Computerized Cognitive Behavioral Therapy In Persistent Postural Perceptual Dizziness

Objective:1.To construct a computerized cognitive-behavioral therapy intervention program for patients with Persistent Postural-Perceptual Dizziness(PPPD).2.To investigate the effect of computerized cognitive behavioral therapy on the improvement of dizziness symptoms,negative emotions and balance function in patients with PPPD.Methods:1.Program Construction: Firstly,a literature review was conducted to understand the current status of domestic and international research in the treatment of PPPD and functional dizziness,and to provide ideas for the identification of research topics and innovations.Secondly,based on literature analysis,the general characteristics of the high-quality literature in this field and the targets,contents and efficacy of interventions were analyzed to form a first draft.Then a multidisciplinary team of experts was formed,and the integrated model of anxiety and postural control and the cognitive model of anxiety and depression were used as the theoretical framework to refine the specific content and implementation process through expert group meetings and pre-experiments,and finally formed a computerized cognitive-behavioral therapy intervention program for patients with PPPD.2.Intervention studies: In this study,a double-blind randomized controlled trial design was used to select patients with PPPD who were also combining mild or above negative emotions who attended the Department of Otolaryngology-Head and Neck Surgery in a tertiary care hospital in Shanxi Province from July 2020 to July 2021 as study subjects,and a total of 86 cases were included and randomly divided into 43 cases in the experimental group and 43 cases in the control group.The control group was given conventional treatment for PPPD(medication and vestibular rehabilitation),and the experimental group implemented computerized cognitive behavioral therapy based on the treatment of the control group.The general information of the patients was collected at the time of enrollment,and their dizziness symptoms,negative emotions and balance functions were assessed by questionnaire method before and 4 and 8 weeks after the intervention using the Dizziness Handicap Inventory(DHI),Generalized Anxiety Disorder(GAD-7),Patient Health Questionnaire(PHQ-9)and Berg Balance Scale(BBS),respectively.Finally,SPSS 26.0 software was applied for statistical analysis,and repeated measures ANOVA was used to evaluate the effectiveness of computerized cognitive behavioral therapy in patients with PPPD.Results:1.Program Construction: Using literature analysis,multidisciplinary expert meetings,pre-experiments and clinical research,a computerized cognitive behavioral therapy intervention program for PPPD patients was constructed,divided into two phases with a total of nine interventions,each of which included three parts: cognitive therapy,behavioral therapy and homework.The computerized cognitive behavioral therapy application developed by the hospital was used in the outpatient treatment room,and the mobile network based We Chat platform was used in the home follow-up period.The intervention was conducted once a week for 8 weeks on average,starting from the diagnosis of the group.2.Intervention studies: There were no statistically significant differences between the two groups in general demographic data such as age,gender,and marriage(P > 0.05),and there were no statistically significant differences in all indicators between the two groups before the intervention(P > 0.05).Comparison of the two groups of patients before and after the intervention revealed:(1)Comparison of subjective symptoms: The differences in DHI scores and sub-dimensions measured at different time points between the two groups were statistically significant,and there was a time effect and interaction effect(P < 0.05);when further compared at 4 and 8 weeks after the intervention,the DHI scores and sub-dimensions of the test group were better than those of the control group,and the differences were statistically significant,and there was a between-group effect(P <0.05).(2)Comparison of negative emotions: The GAD-7 and PHQ-9 scores measured at different time points of the two groups were statistically significant,and there were time and interaction effects(P < 0.05);when further compared at 4 and 8 weeks after the intervention,the GAD-7 and PHQ-9 scores of the test group were better than those of the control group,and the differences were statistically significant,and there were between-group effects(P < 0.05).(3)Comparison of balance function: The BBS scores of both groups were statistically significant at different time points,and there were time and interaction effects(P < 0.05);further comparison at 4 and 8 weeks after the intervention,the BBS scores of the test group were not better than those of the control group,and the differences were not statistically significant,and there was no between-group effect(P > 0.05).In addition,no serious adverse reactions occurred in either group during the intervention period.Conclusion:Negative emotions and cognitive deficits are common in patients with PPPD.The computerized cognitive behavioral therapy intervention program constructed in this study can effectively alleviate dizziness symptoms,improve negative emotions,and enhance balance function in patients with PPPD.It improves the efficiency of patient follow-up treatment while maximizing the utilization of medical resources,and can be used as an adjunctive treatment modality for PPPD patients in clinical settings,but the improvement of balance function did not show additional benefits.