Effectiveness of an internet-based self-guided program to treat depression in a sample of Brazilian users: a study protocol

Abstract

Although psychological treatments for depressive disorders are available, they are often expensive or inaccessible for many. Web-based interventions that require minimal or no contact with therapists have been shown effective. To the best of our knowledge, no study using this treatment format has been conducted in Brazil. The Deprexis program was designed using empirically established principles of cognitive-behavioral therapy to reduce depressive symptoms. The objective of this study was to evaluate the effectiveness of Deprexis in Brazil. This randomized controlled trial will include 128 Brazilians with clinically significant depression symptoms or who have been diagnosed with depressive disorder (major depressive disorder or dysthymia), recruited over the internet (Brazilian forums, social networks, or e-mail lists). Individuals with other psychiatric diagnoses that require significant attention (e.g., bipolar disorder, psychosis) will not be included in the trial. Participants will be randomly assigned to 1) treatment as usual plus immediate access to Deprexis or 2) treatment as usual plus delayed access to Deprexis (after 8 weeks). Participants will be able to obtain other treatment types in addition to the online intervention. If found effective, this web-based intervention would increase the evidence-based care options for depression treatment in Brazil.

Who seeks Internet-based interventions for depression in Brazil?

“…This study uses data from an ongoing clinical trial that aims to assess the effectiveness of Deprexis® (Lopes, Meyer, Berger, & Svacina, 2020). This Internet-based intervention helps people cope with depressive symptoms (Meyer et al, 2009).…”

Assessing Patient Adherence to and Engagement With Digital Interventions for Depression in Clinical Trials: Systematic Literature Review

“…The majority of the studies reviewed in this SLR offered some form of support in various ways. Support was sometimes marginal, such as a 10-minute phone call in the second week of the intervention [ 90 ], minimal email contact with psychologists [ 133 ], or an optional onboarding phone call [ 131 ]. Support could also be intensive, such as a psychiatrist appointment, 12 weekly 30- to 60-minute phone calls with a coach, and written contact between appointments [ 161 ].…”

Aliança terapêutica na terapia cognitivo-comportamental baseada em internet: uma revisão narrativa

“…Os tratamentos que não envolvem o contato com o clínico podem ser programas de psicoeducação, grupos de apoio online e programas de intervenção guiados ou não, contando com a ajuda de materiais informativos como livros, folhetos ou vídeos (Andersson, 2020). No Brasil esses programas ainda não são populares, mas já contam com estudos que visam a sua implementação, como o Deprexis, focado em depressão (Lopes, Meyer, Berger & Svacina, 2020), e outro voltado para Transtorno Obsessivo Compulsivo (TOC; Siegmund, Nonohay & Gauer, 2016), ambos IBI's com embasamento cognitivo-comportamental. Tais programas contam com contato mínimo com profissionais, sendo os primeiros estudos com esse objetivo no Brasil.…”