Diminishing Effects After Recurrent Use of Self-Guided Internet-Based Interventions in Depression: Randomized Controlled Trial.
depressive symptoms
eHealth
randomized controlled trial
self-management
Journal
Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882
Informations de publication
Date de publication:
02 10 2019
02 10 2019
Historique:
received:
02
04
2019
accepted:
19
07
2019
revised:
19
06
2019
entrez:
4
10
2019
pubmed:
4
10
2019
medline:
12
6
2020
Statut:
epublish
Résumé
Self-guided internet-based interventions have several advantages over guided interventions and are generally effective in treating psychiatric symptoms. We aimed to investigate whether the use of a new self-guided internet-based intervention (MOOD) would lead to a significant reduction in depressive symptoms compared with a care-as-usual (CAU) control group in a sample of individuals with depressive symptoms, most of whom had already used a different self-guided internet-based intervention in a previous trial. A total of 125 individuals were randomized to the intervention condition (MOOD) and received access to the intervention for a period of six weeks or a CAU group. After six weeks, all participants were invited to take part in the post assessment. The Beck Depression Inventory-II served as the primary outcome. Both intention-to-treat as well as per-protocol analyses indicated that the depressive symptomatology decreased in both conditions but showed no advantage for those who had used MOOD. Subsequent moderation analyses suggested that those individuals who had less experience with psychotherapy benefitted to a greater extent compared with those with more experience. Self-guided internet-based interventions are deemed a suitable first-step approach to the treatment of depression. However, our results indicate that they are more efficacious in those with less psychotherapy experience. ClinicalTrials.gov NCT03795480; http://clinicaltrials.gov/ct2/show/NCT03795480.
Sections du résumé
BACKGROUND
Self-guided internet-based interventions have several advantages over guided interventions and are generally effective in treating psychiatric symptoms.
OBJECTIVE
We aimed to investigate whether the use of a new self-guided internet-based intervention (MOOD) would lead to a significant reduction in depressive symptoms compared with a care-as-usual (CAU) control group in a sample of individuals with depressive symptoms, most of whom had already used a different self-guided internet-based intervention in a previous trial.
METHODS
A total of 125 individuals were randomized to the intervention condition (MOOD) and received access to the intervention for a period of six weeks or a CAU group. After six weeks, all participants were invited to take part in the post assessment. The Beck Depression Inventory-II served as the primary outcome.
RESULTS
Both intention-to-treat as well as per-protocol analyses indicated that the depressive symptomatology decreased in both conditions but showed no advantage for those who had used MOOD. Subsequent moderation analyses suggested that those individuals who had less experience with psychotherapy benefitted to a greater extent compared with those with more experience.
CONCLUSIONS
Self-guided internet-based interventions are deemed a suitable first-step approach to the treatment of depression. However, our results indicate that they are more efficacious in those with less psychotherapy experience.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03795480; http://clinicaltrials.gov/ct2/show/NCT03795480.
Identifiants
pubmed: 31579014
pii: v21i10e14240
doi: 10.2196/14240
pmc: PMC6777284
doi:
Banques de données
ClinicalTrials.gov
['NCT03795480']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14240Informations de copyright
©Lara Bücker, Patricia Schnakenberg, Eirini Karyotaki, Steffen Moritz, Stefan Westermann. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.10.2019.
Références
Clin Psychol Rev. 2013 Aug;33(6):763-71
pubmed: 23796855
Can J Psychiatry. 2013 Jul;58(7):376-85
pubmed: 23870719
World Psychiatry. 2014 Oct;13(3):288-95
pubmed: 25273302
Psychol Med. 1998 May;28(3):551-8
pubmed: 9626712
Bull World Health Organ. 2004 Nov;82(11):858-66
pubmed: 15640922
Psychother Psychosom. 2016;85(4):231-4
pubmed: 27230865
J Clin Psychol. 2013 Sep;69(9):994-1011
pubmed: 23630010
Psychol Med. 2015 Jan;45(1):11-27
pubmed: 24569086
Med J Aust. 2010 Jun 7;192(S11):S36-9
pubmed: 20528706
Aust N Z J Psychiatry. 2014 Jun;48(6):571-8
pubmed: 24413807
J Affect Disord. 2018 Feb;227:455-462
pubmed: 29154168
Sci Rep. 2018 Feb 12;8(1):2861
pubmed: 29434331
JAMA Psychiatry. 2017 Apr 1;74(4):351-359
pubmed: 28241179
Psychol Med. 2018 Nov;48(15):2456-2466
pubmed: 29540243
Clin Psychol Rev. 2012 Jun;32(4):329-42
pubmed: 22466510
Psychother Psychosom. 2016;85(4):218-28
pubmed: 27230863
Dialogues Clin Neurosci. 2016 Jun;18(2):203-12
pubmed: 27489460
J Clin Psychol. 2010 Apr;66(4):394-409
pubmed: 20127795
Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S454-66
pubmed: 22588766
Psychol Med. 2014 Apr;44(6):1303-17
pubmed: 23931656
Am J Med. 2015 Sep;128(9 Suppl):S1-S15
pubmed: 26337210
Clin Psychol Rev. 2007 Apr;27(3):318-26
pubmed: 17184887
Internet Interv. 2018 Jun 28;13:73-81
pubmed: 30206522
Neuropsychiatr Dis Treat. 2011;7(Suppl 1):3-7
pubmed: 21750622
Qual Life Res. 2004 Mar;13(2):299-310
pubmed: 15085902
Perspect Clin Res. 2016 Jan-Mar;7(1):51-3
pubmed: 26952180
Clin Psychol Rev. 2006 Oct;26(6):657-78
pubmed: 15908088
Expert Rev Pharmacoecon Outcomes Res. 2012 Dec;12(6):745-64
pubmed: 23252357
World Psychiatry. 2013 Jun;12(2):137-48
pubmed: 23737423
World Psychiatry. 2014 Feb;13(1):4-11
pubmed: 24497236
BMJ. 2001 Nov 10;323(7321):1123-4
pubmed: 11701584
JMIR Ment Health. 2016 Feb 09;3(1):e9
pubmed: 26860537
Clin Psychol Rev. 2007 Dec;27(8):959-85
pubmed: 17448579
Cogn Behav Ther. 2011;40(4):251-66
pubmed: 22060248
J Med Internet Res. 2011 Aug 05;13(3):e52
pubmed: 21821503
Psychol Med. 2015 Oct;45(13):2717-26
pubmed: 25881626
Psychol Sci Public Interest. 2002 Nov;3(2):39-77
pubmed: 26151569
J Consult Clin Psychol. 2010 Apr;78(2):169-83
pubmed: 20350028
BMC Psychiatry. 2010 Dec 30;10:113
pubmed: 21192795
J Clin Psychol. 2011 Feb;67(2):184-92
pubmed: 21128304
J Consult Clin Psychol. 2001 Jun;69(3):347-57
pubmed: 11495165
Clin Psychol Rev. 2000 Apr;20(3):379-403
pubmed: 10779900
J Clin Psychol. 2003 Mar;59(3):341-9
pubmed: 12579549
Behav Res Methods. 2007 May;39(2):175-91
pubmed: 17695343
Behav Res Ther. 2004 Jun;42(6):711-29
pubmed: 15081886
Psychol Med. 2018 Jul;48(10):1644-1654
pubmed: 29095133
J Consult Clin Psychol. 2018 Jun;86(6):493-504
pubmed: 29781648
Psychiatr Serv. 2014 Jan 1;65(1):24-32
pubmed: 24081188
Psychol Med. 2016 Oct;46(13):2679-93
pubmed: 27649340
J Med Internet Res. 2017 Sep 15;19(9):e306
pubmed: 28916506
PLoS One. 2013 Jul 03;8(7):e62873
pubmed: 23843932
PLoS One. 2014 Jul 16;9(7):e100674
pubmed: 25029507
Psychother Psychosom Med Psychol. 1989 Jul;39(7):248-55
pubmed: 2762479
Cogn Behav Ther. 2018 Jan;47(1):1-18
pubmed: 29215315
J Consult Clin Psychol. 2000 Aug;68(4):615-23
pubmed: 10965637
Pharmaceuticals (Basel). 2010 Aug 03;3(8):2426-2440
pubmed: 27713362
Sleep Med Clin. 2015 Mar;10(1):17-23
pubmed: 26055669
Nord J Psychiatry. 2011 Dec;65(6):354-64
pubmed: 21770842
Dialogues Clin Neurosci. 2008;10(4):473-81
pubmed: 19170404
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
J Ment Health Policy Econ. 2006 Jun;9(2):87-98
pubmed: 17007486
Behav Res Ther. 2012 Aug;50(7-8):513-21
pubmed: 22677231
BMJ. 2013 Feb 26;346:f540
pubmed: 23444423
Br J Clin Psychol. 2010 Nov;49(Pt 4):455-71
pubmed: 19799804
Clin Psychol Rev. 2018 Jul;63:80-92
pubmed: 29940401