This study identifies online CBT as a viable alternative in the treatment of bulimic symptoms.

Depression is common but undertreated. Web-based self-help provides a widely accessible treatment alternative for mild to moderate depression. However, the lack of therapist guidance may limit its efficacy. The authors assess the efficacy of therapist-guided web-based cognitive behavioural treatment (web-CBT) of mild to moderate depression. Fifty-four individuals with chronic, moderate depression participated in a randomized wait-list controlled trial, with an 18-month follow-up (immediate treatment: n = 36, wait-list control: n = 18). Primary outcome measures were the Beck Depression Inventory (BDI-IA) and the Depression scale of the Symptom Checklist-90-Revised (SCL-90-R. DEP). Secondary outcome measures were the Depression Anxiety Stress Scales and the Well-Being Questionnaire. Five participants (9%) dropped out. Intention-to-treat analyses of covariance revealed that participants in the treatment condition improved significantly more than those in the wait-list control condition (.011 < p < .015). With regard to the primary measures, between-group effects (d) were 0.7 for the BDI-IA and 1.1 for the SCL-90-R DEP. Posttest SCL-90- R DEP scores indicated recovery of 49% of the participants in the treatment group compared with 6% in the control group (odds ratio = 14.5; p < .004). On average, the effects were stable up to 18 months (n = 39), although medication was a strong predictor of relapse. The results demonstrate the efficacy of web-CBT for mild to moderate depression and the importance of therapist guidance in psychological interventions.

The aim of this study was to assess the effects of a 7-week standardized cognitive behavioural treatment of work-related stress conducted via e-mail. A total of 342 people applied for treatment in reaction to a newspaper article. Initial screening reduced the sample to a heterogeneous (sub)clinical group of 239 participants. Participants were assigned randomly to a waiting list condition (n = 62), or to immediate treatment (n = 177). A follow-up was conducted 3 years after inception of the treatment. The outcome measures used were the Depression Anxiety Stress Scales (DASS-42) and the Emotional Exhaustion scale of the Maslach Burnout Inventory - General Survey (MBI-GS). Fifty participants (21%) dropped out. Both groups showed statistically significant improvements. Intention-to-treat analysis of covariance (ANCOVAs) revealed that participants in the treatment condition improved significantly more than those in the waiting control condition (0.001

or = d > or = 0.5 (anxiety)). The between-group effects ranged from d = 0.6 (stress) to d = 0.1 (anxiety). At follow-up, the effects were more pronounced, but this result requires replication in view of high attrition at follow-up. The results warrant further research on Internet-driven standardized cognitive behavioural therapy for work-related stress. Such research should include the direct comparison of this treatment with face-to-face treatment, and should address the optimal level of therapist contact in Internet-driven treatment.

No abstract

De eerste Interapy-behandeling via het internet is in 1999 gepubliceerd. Die betrof posttraumatische stress. Daarna zijn vele studies en publicaties gevolgd. Dit artikel beschrijft de achtergrond van de Interapybehandelingen, de screening, de procedures, de instrumenten, de interventies en de resultaten van de drie behandelprotocollen die in gerandomiseerde vergelijkende studies zijn getest. Het gaat hierbij om posttraumatische stress, burn-out en depressie. De effecten van de behandelingen blijken groot te zijn. Bij wijze van illustratie wordt de behandeling van e´e´n clie¨nte (met depressie) beschreven. Daarnaast wordt verslag gedaan van de subjectieve beoordelingen door de clie¨nten van de verschillende behandelelementen, van de procedures en van de therapeuten. In de discussie worden de resultaten besproken. Kakes (2004) bespreekt negen gerandomiseerde gecontroleerde onderzoeken naar internetbehandelingen voor depressie, angststoornissen, eetstoornis en posttraumatische stressstoornis. Hij vergelijkt de manieren van screening, mate van structuur van de behandeling, hoeveelheid persoonlijke begeleiding, effectiviteit en mate waarin er naast de internetcommunicatie gebruik wordt gemaakt van vis-a`-viscontacten. Het blijkt dat er nagenoeg geen internetbehandelingen zijn die volledig via het internet verlopen. Bij de meeste zijn er standaard ook telefonische contacten voor de screening en voor het geven van informatie. Veel van de internetbehandelingen bestaan vooral uit psycho-educatie en vaste richtlijnen, zonder dat de clie¨nten feedback krijgen over de manier waarop ze omgaan met de geboden interventies. Dat soort internetbehandelingen overstijgt de zelfhulp niet noemenswaardig.Het Interapy-programma gaat verder. De opzet en resultaten van de verschillende Interapy-behandelingen zijn eerder beschreven (zie bovenstaande literatuurverwijzingen en de website http://users.fmg.uva.nl/alange). In dit artikel geven wij een overzicht van de Interapyprocedure, een korte beschrijving van de interventies in de tot nu toe geteste behandelingen en een samenvatting

BackgroundThe Four-Dimensional Symptom Questionnaire (4DSQ) (Huisarts Wetenschap 39: 538–47, 1996) is a self-report questionnaire developed in the Netherlands to distinguish non-specific general distress from depression, anxiety, and somatization. This questionnaire is often used in different populations and settings and there is a paper-and-pencil and computerized version.MethodsWe used item response theory to investigate whether the 4DSQ measures the same construct (structural equivalence) in the same way (scalar equivalence) in two samples comprised of primary mental health care attendees: (i) clients who visited their General Practitioner responded to the 4DSQ paper-and-pencil version, and (ii) eHealth clients responded to the 4DSQ computerized version. Specifically, we investigated whether the distress items functioned differently in eHealth clients compared to General Practitioners’ clients and whether these differences lead to substantial differences at scale level.ResultsResults showed that in general structural equivalence holds for the distress scale. This means that the distress scale measures the same construct in both General Practitioners’ clients and eHealth clients. Furthermore, although eHealth clients have higher observed distress scores than General Practitioners’ clients, application of a multiple group generalized partial credit response model suggests that scalar equivalence holds.ConclusionsThe same cutoff scores can be used for classifying respondents as having low, moderate and high levels of distress in both settings.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1552-3) contains supplementary material, which is available to authorized users.

5 Opvallend was dat de fracties van SP en PVV, toch de fracties die de meeste vragen stellen en spoeddebatten initiëren, hierbij afwezig waren.

No abstract