Louise Mewton1, Gavin Andrews2. 1. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia. Electronic address: louisem@unsw.edu.au. 2. School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia.
Abstract
BACKGROUND: Depression is a major risk factor for suicide. Given the strong association between depression and suicide, treatment for depression should be a fundamental component of suicide prevention. Currently it is not. This study aims to demonstrate the usefulness of internet-delivered cognitive behavioural therapy (iCBT) for depression as a means of reducing suicide ideation. METHODS: The sample comprised 484 patients who were prescribed iCBT for depression by their primary care physician. The outcomes of interest were major depression, as indexed by the PHQ-8, and suicidal ideation as measured by question 9 of the PHQ-9. Marginal models were used to appropriately analyse available data without biasing parameter estimates. RESULTS: Following iCBT for depression, suicidal ideation and depression decreased in parallel over time. The prevalence of suicidal ideation reduced from 50% at baseline to 27% after treatment, whilst the prevalence of major depression reduced from 70% to 30%. Depression scores and suicidal ideation decreased after treatment regardless of demographic or clinical variables of interest. LIMITATIONS: This is a naturalistic study; randomisation and scientific control were not possible. CONCLUSIONS: The current study demonstrates the usefulness of iCBT for depression as a means of reducing suicidal ideation which can be implemented on a large scale without enacting major structural change at the societal level. These findings need to be replicated in randomised controlled trials.
BACKGROUND:Depression is a major risk factor for suicide. Given the strong association between depression and suicide, treatment for depression should be a fundamental component of suicide prevention. Currently it is not. This study aims to demonstrate the usefulness of internet-delivered cognitive behavioural therapy (iCBT) for depression as a means of reducing suicide ideation. METHODS: The sample comprised 484 patients who were prescribed iCBT for depression by their primary care physician. The outcomes of interest were major depression, as indexed by the PHQ-8, and suicidal ideation as measured by question 9 of the PHQ-9. Marginal models were used to appropriately analyse available data without biasing parameter estimates. RESULTS: Following iCBT for depression, suicidal ideation and depression decreased in parallel over time. The prevalence of suicidal ideation reduced from 50% at baseline to 27% after treatment, whilst the prevalence of major depression reduced from 70% to 30%. Depression scores and suicidal ideation decreased after treatment regardless of demographic or clinical variables of interest. LIMITATIONS: This is a naturalistic study; randomisation and scientific control were not possible. CONCLUSIONS: The current study demonstrates the usefulness of iCBT for depression as a means of reducing suicidal ideation which can be implemented on a large scale without enacting major structural change at the societal level. These findings need to be replicated in randomised controlled trials.
Authors: Juan-Luis Muñoz-Sánchez; Carmen Delgado; Andrés Sánchez-Prada; Mercedes Pérez-López; Manuel A Franco-Martín Journal: JMIR Ment Health Date: 2017-06-27
Authors: Anne Etzelmueller; Christiaan Vis; Eirini Karyotaki; Harald Baumeister; Nickolai Titov; Matthias Berking; Pim Cuijpers; Heleen Riper; David Daniel Ebert Journal: J Med Internet Res Date: 2020-08-31 Impact factor: 5.428