Clinical effectiveness of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial

Abstract

BackgroundComputerised cognitive–behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression.AimsTo determine the clinical effectiveness of online, unsupported CCBT for depression in primary care.MethodThree hundred and three people with depression were randomly allocated to one of three groups: Colour Your Life; treatment as usual (TAU) by a general practitioner; or Colour Your Life and TAU combined. Colour Your Life is an online, multimedia, interactive CCBT programme. No assistance was offered. We had a 6-month follow-up period.ResultsNo significant differences in outcome between the three interventions were found in the intention-to-treat and per protocol analyses.ConclusionsOnline, unsupported CCBT did not outperform usual care, and the combination of both did not have additional effects. Decrease in depressive symptoms in people with moderate to severe depression was moderate in all three interventions. Online CCBT without support is not beneficial for all individuals with depression.

Computer-based psychological treatments for depression: A systematic review and meta-analysis

“…Some RCT studies reported their objective was to establish the efficacy of a computer-based, clinician-assisted, intervention for depression Perini, Titov, & Andrews, 2009;, others examined the efficacy of unsupported computer-based interventions de Graaf et al, 2009;Meyer et al, 2009;Spek, Cuijpers et al, 2007). Others still in examining efficacy included support which was other than therapeutic (Christensen, Griffiths, & Jorm, 2004;.…”

“…The Colour your Life program (3 RCTs) was initially developed for use with over 50-years population (Spek, Nyklicek et al, 2007) and later adapted for use with an adult population (18-65;de Graaf et al, 2009;Warmerdam, van Straten, Twisk, Riper, & Cuijpers, 2008). It consisted of sessions on psycho-education, cognitive restructuring, behavior change, and relapse prevention.…”

“…In a number of studies the postal system was used to send prospective participants a letter of invite Clarke et al, 2002Clarke et al, , 2005Christensen et al, 2004;de Graaf et al, 2009;. The majority of open trials and some RCTs recruited participants from primary or secondary care services.…”

A secondary analysis of internet-delivered cognitive-behaviour treatment for adults with severe depressive symptoms (Preprint)

“…The National Institute for Health and Care Excellence (NICE) guidelines recommend iCBT as a treatment option in the management of mild to moderate depression [16]. The majority of studies have focused on participants who present with mild to moderate symptom severity meaning the evidence base investigating how internet-delivered interventions impact on severe depression symptoms is less established [17].…”

Telepsiquiatría: una revisión sistemática cualitativa

“…Un ECC con tres brazos comparó un tratamiento computarizado de orientación cognitivo conductual administrado en línea llamado "Coloree su vida", el manejo usual de la depresión llevado a cabo por un médico general y ambos juntos no encontrándose diferencias signifi cativas a los seis meses entre estas tres posibilidades en relación a sintomatología depresiva y calidad de vida 15 ;sin embargo, los análisis costo efectividad favorecían al tratamiento cognitivo conductual solo 16 . Cinco ECC prueban el uso del teléfono en el tratamiento de la depresión.…”