Rosa E Boeschoten1, Joost Dekker2, Bernard Mj Uitdehaag3, Aartjan Tf Beekman1, Adriaan W Hoogendoorn1, Emma H Collette4, Pim Cuijpers5, Magdalena M Nieuwenhuis1, Patricia van Oppen1. 1. EMGO+ Institute for Mental Health and Care Research/Department of Psychiatry, VU University Medical Center/GGZinGeest, Amsterdam, The Netherlands. 2. Department of Psychiatry, VU University Medical Center/GGZinGeest, Amsterdam, The Netherlands/EMGO+ Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, The Netherlands. 3. Department of Neurology, Multiple Sclerosis Center, VU University Medical Center, Amsterdam, The Netherlands. 4. Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands. 5. EMGO+ Institute for Mental Health and Care Research, VU University, Amsterdam, The Netherlands/Department of Clinical, Neuro & Developmental Psychology, VU University, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Depression in multiple sclerosis (MS) patients is common but may stay untreated. Physical limitations impede face-to-face treatment. Internet-based treatment is therefore a promising tool for treating depression in MS. OBJECTIVES: To investigate effectiveness of a guided Internet-based problem-solving treatment (IPST) for depressed MS patients. METHODS:MS patients with moderate or severe depressive symptoms were randomly assigned to IPST or a wait list control. Primary outcome was the change in depressive symptoms defined by a change in sum score on the Beck Depression Inventory Second Edition (BDI-II). Assessments took place at baseline (T0), within a week after the intervention (T1), and at 4 months follow-up (T2). Analyses were based on the intention-to-treat principle. RESULTS: A total of 171 patients were randomized to IPST ( n = 85) or a wait list control ( n = 86). T1 was completed by 152 (89%) and T2 by 131 patients (77%). The IPST group and wait list control showed large significant improvements in depressive symptoms, but no differences were found between groups at T1 ( d = 0.23; 95% confidence interval (CI) = (-4.03, 1.08); p = 0.259) and T2 ( d = 0.01; 95% CI = (-2.80, 2.98); p = 0.953). CONCLUSION: We found no indication that IPST for MS patients with moderate or severe depression is effective in reducing depressive symptoms compared to a waiting list. Large improvements in the wait list control were unexpected and are discussed.
RCT Entities:
BACKGROUND:Depression in multiple sclerosis (MS) patients is common but may stay untreated. Physical limitations impede face-to-face treatment. Internet-based treatment is therefore a promising tool for treating depression in MS. OBJECTIVES: To investigate effectiveness of a guided Internet-based problem-solving treatment (IPST) for depressed MSpatients. METHODS:MSpatients with moderate or severe depressive symptoms were randomly assigned to IPST or a wait list control. Primary outcome was the change in depressive symptoms defined by a change in sum score on the Beck Depression Inventory Second Edition (BDI-II). Assessments took place at baseline (T0), within a week after the intervention (T1), and at 4 months follow-up (T2). Analyses were based on the intention-to-treat principle. RESULTS: A total of 171 patients were randomized to IPST ( n = 85) or a wait list control ( n = 86). T1 was completed by 152 (89%) and T2 by 131 patients (77%). The IPST group and wait list control showed large significant improvements in depressive symptoms, but no differences were found between groups at T1 ( d = 0.23; 95% confidence interval (CI) = (-4.03, 1.08); p = 0.259) and T2 ( d = 0.01; 95% CI = (-2.80, 2.98); p = 0.953). CONCLUSION: We found no indication that IPST for MSpatients with moderate or severe depression is effective in reducing depressive symptoms compared to a waiting list. Large improvements in the wait list control were unexpected and are discussed.
Authors: Els Nadort; Robbert W Schouten; Friedo W Dekker; Adriaan Honig; Patricia van Oppen; Carl E H Siegert Journal: BMC Psychiatry Date: 2019-11-27 Impact factor: 3.630
Authors: William Bevens; Tracey Weiland; Kathleen Gray; George Jelinek; Sandra Neate; Steve Simpson-Yap Journal: J Med Internet Res Date: 2022-02-09 Impact factor: 5.428