Effectiveness and dissemination of computer-based cognitive behavioral therapy for depressed adolescents: Effective and accessible to whom?

Do, Ryemi; Lee, Song Yi; Kim, Jee Soo; Cho, Minji; Shin, Hanbyul; Jang, Mirae; Shin, Min Sup

doi:10.1016/j.jad.2020.12.177

Cited by 9 publications

(4 citation statements)

References 50 publications

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“…A total of 5.4% (6/111) of the studies did not report the participants’ ages [ 76 , 85 , 88 , 101 , 104 , 116 ]. The mean age across the remaining 94.6% (105/111) of the studies was 40.9 (SD 11.6, median 42.3, range 15.8-69.6) years.…”

Section: Resultsmentioning

confidence: 99%

“…The studies had an average of 74% female participants (median 76.6%, range 12.4%-100%). In 7.2% (8/111) of the studies, sex was not reported [76,95,96] or was reported for the total sample but not separated for the different conditions [97][98][99][100][101]. In total, 8.1% (9/111) of the studies included only women and had treatments directed at maternal depression [84,87,88,[102][103][104][105], patients with breast cancer [106], or female adolescents [107].…”

Section: Sex Of Participantsmentioning

confidence: 99%

See 1 more Smart Citation

Guided Internet-Delivered Treatment for Depression: Scoping Review

Børtveit¹,

Dechsling²,

Sütterlin³

et al. 2022

JMIR Ment Health

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Background Studies on guided internet-delivered treatment have demonstrated promising results for patients with depressive disorder. Objective The aim of this study was to provide an overview of this research area and identify potential gaps in the research. Methods In this scoping review, web-based databases were used to identify research papers published between 2010 and 2022 where guided internet-delivered treatment was administered to participants with depressive disorders, a standardized rating scale of depressive symptoms was used as the primary outcome measure, and the treatment was compared with a control condition. Results A total of 111 studies were included, and an overview of the studies was provided. Several gaps in the research were identified regarding the design of the studies, treatments delivered, participant representation, and treatment completion. Conclusions This review provides a comprehensive overview of the research area, and several research gaps were identified. The use of other designs and active control conditions is recommended. Future studies should provide access to treatment manuals, and more replications should be conducted. Researchers should aim to include underrepresented populations and provide reports of comorbidities. Definitions of adequate dosage, reports of completion rates, and reasons for treatment dropout are recommended for future studies.

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Section: Resultsmentioning

confidence: 99%

Section: Sex Of Participantsmentioning

confidence: 99%

Guided Internet-Delivered Treatment for Depression: Scoping Review

Børtveit¹,

Dechsling²,

Sütterlin³

et al. 2022

JMIR Ment Health

View full text Add to dashboard Cite

show abstract

“…We included 102 trials comprising a total of 19 758 participants with a mean (SD) age of 39.9 (10.58) years, a mean (SD) percentage of female participants of 69.13% (12.22), and moderate depression severity across the studies (mean [SD] Patient Health Questionnaire–9 score, 12.81 [2.93]). The PRISMA flowchart and more information about the dataset can be found in eAppendices 4 and 5 in Supplement 1 and the eTable in Supplement 2.…”

Section: Resultsmentioning

confidence: 99%

Heterogeneity of Treatment Effects in Internet- and Mobile-Based Interventions for Depression

Terhorst,

Kaiser,

Brakemeier

et al. 2024

JAMA Netw Open

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ImportanceWhile the effects of internet- and mobile-based interventions (IMIs) for depression have been extensively studied, no systematic evidence is available regarding the heterogeneity of treatment effects (HTEs), indicating to what extent patient-by-treatment interactions exist and personalized treatment models might be necessary.ObjectiveTo investigate the HTEs in IMIs for depression as well as their efficacy and effectiveness.Data SourcesA systematic search in Embase, MEDLINE, Central, and PsycINFO for randomized clinical trials and supplementary reference searches was conducted on October 13, 2019, and updated March 25, 2022. The search string included various terms related to digital psychotherapy, depression, and randomized clinical trials.Study SelectionTitles, abstracts, and full texts were reviewed by 2 independent researchers. Studies of all populations with at least 1 intervention group receiving an IMI for depression and at least 1 control group were eligible, if they assessed depression severity as a primary outcome and followed a randomized clinical trial (RCT) design.Data Extraction and SynthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Risk of bias was evaluated using the Cochrane Risk of Bias Tool. HTE was investigated using logarithmic variance ratios (lnVR) and effect sizes using Hedges g. Three-level bayesian meta-regressions were conducted.Main Outcomes and MeasuresHeterogeneity of treatment effects was the primary outcome of this study; magnitudes of treatment effect sizes were the secondary outcome. Depression severity was measured by different self-report and clinician-rated scales in the included RCTs.ResultsThe systematic review of 102 trials included 19 758 participants (mean [SD] age, 39.9 [10.58] years) with moderate depression severity (mean [SD] in Patient Health Questionnaire–9 score, 12.81 [2.93]). No evidence for HTE in IMIs was found (lnVR = −0.02; 95% credible interval [CrI], −0.07 to 0.03). However, HTE was higher in more severe depression levels (β̂ = 0.04; 95% CrI, 0.01 to 0.07). The effect size of IMI was medium (g = −0.56; 95% CrI, −0.46 to −0.66). An interaction effect between guidance and baseline severity was found (β̂ = −0.24, 95% CrI, −0.03 to −0.46).Conclusions and RelevanceIn this systematic review and meta-analysis of RCTs, no evidence for increased patient-by-treatment interaction in IMIs among patients with subthreshold to mild depression was found. Guidance did not increase effect sizes in this subgroup. However, the association of baseline severity with HTE and its interaction with guidance indicates a more sensitive, guided, digital precision approach would benefit individuals with more severe symptoms. Future research in this population is needed to explore personalization strategies and fully exploit the potential of IMI.

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“…A meta-analytic review (12 trials, 1576 participants) of RCTs of CBT and other psychotherapies for subthreshold depression found short-term reduction in depressive symptoms (effect size = 0.38, 95% CI 0.14–0.63) but no impact on the likelihood of developing MDD in the ensuing 12 months (RR = 0.52, 95% CI 0.25–1.08) [7 ▪▪ ]. Two subsequent RCTs have reported short-term reductions in symptoms but have not reported effects on progression to MDD [8,9].…”

Section: Prevention and Early Interventionmentioning

confidence: 99%

Updates in treatment of depression in children and adolescents

Hazell

2021

Current Opinion in Psychiatry

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Purpose of review To examine recent evidence that informs the treatment of depression in children and adolescents. Recent findings There are no new leads in the prevention and early intervention of depression in children and adolescents. For acute treatment of major depressive disorder, talking therapies are moving increasingly to internet-based platforms. Family therapy may have a slight edge over individual psychotherapy in the short-term. Patients with severe depression with endogenous features have a more robust response to pharmacotherapy than do patients with mild-to-moderate depression. Findings in relation to reward sensitivity and changes in brain-derived neurotrophic factor levels contradict research conducted in adults, suggesting developmental differences in the mechanisms underlying depression. Ketamine infusion could have a role for adolescents with treatment refractory depression. There was no new evidence concerning relapse prevention. Summary Most new findings have been concerned with moderators and mediators of treatment.

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Effectiveness and dissemination of computer-based cognitive behavioral therapy for depressed adolescents: Effective and accessible to whom?

Cited by 9 publications

References 50 publications

Guided Internet-Delivered Treatment for Depression: Scoping Review

Guided Internet-Delivered Treatment for Depression: Scoping Review

Heterogeneity of Treatment Effects in Internet- and Mobile-Based Interventions for Depression

Updates in treatment of depression in children and adolescents

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