BACKGROUND: Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI. METHODS:Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling. RESULTS: Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: dIC = 1.53, dCoD = 1.37; Patient Health Questionnaire-9: dIC = 1.20, dCoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions. CONCLUSION: Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition.
RCT Entities:
BACKGROUND: Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI. METHODS:Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling. RESULTS: Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: dIC = 1.53, dCoD = 1.37; Patient Health Questionnaire-9: dIC = 1.20, dCoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions. CONCLUSION: Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition.
Authors: Moritz Köhnen; Levente Kriston; Martin Härter; Harald Baumeister; Sarah Liebherz Journal: J Med Internet Res Date: 2021-06-13 Impact factor: 7.076
Authors: Eirini Karyotaki; Orestis Efthimiou; Clara Miguel; Frederic Maas Genannt Bermpohl; Toshi A Furukawa; Pim Cuijpers; Heleen Riper; Vikram Patel; Adriana Mira; Alan W Gemmil; Albert S Yeung; Alfred Lange; Alishia D Williams; Andrew Mackinnon; Anna Geraedts; Annemieke van Straten; Björn Meyer; Cecilia Björkelund; Christine Knaevelsrud; Christopher G Beevers; Cristina Botella; Daniel R Strunk; David C Mohr; David D Ebert; David Kessler; Derek Richards; Elizabeth Littlewood; Erik Forsell; Fan Feng; Fang Wang; Gerhard Andersson; Heather Hadjistavropoulos; Heleen Christensen; Iony D Ezawa; Isabella Choi; Isabelle M Rosso; Jan Philipp Klein; Jason Shumake; Javier Garcia-Campayo; Jeannette Milgrom; Jessica Smith; Jesus Montero-Marin; Jill M Newby; Juana Bretón-López; Justine Schneider; Kristofer Vernmark; Lara Bücker; Lisa B Sheeber; Lisanne Warmerdam; Louise Farrer; Manuel Heinrich; Marcus J H Huibers; Marie Kivi; Martin Kraepelien; Nicholas R Forand; Nicky Pugh; Nils Lindefors; Ove Lintvedt; Pavle Zagorscak; Per Carlbring; Rachel Phillips; Robert Johansson; Ronald C Kessler; Sally Brabyn; Sarah Perini; Scott L Rauch; Simon Gilbody; Steffen Moritz; Thomas Berger; Victor Pop; Viktor Kaldo; Viola Spek; Yvonne Forsell Journal: JAMA Psychiatry Date: 2021-04-01 Impact factor: 21.596
Authors: Jan Philipp Klein; Andrea Hauer; Thomas Berger; Eva Fassbinder; Ulrich Schweiger; Gitta Jacob Journal: Front Psychiatry Date: 2018-09-21 Impact factor: 4.157