Effectiveness of an Online Group Course for Depression in Adolescents and Young Adults: A Randomized Trial

Abstract

BackgroundDepression is a serious mental health problem, whose first onset is usually in adolescence. Online treatment may offer a solution for the current undertreatment of depression in youth. For adults with depressive symptoms, the effectiveness of Internet-based cognitive behavioral therapy has been demonstrated. This study is one of the first randomized controlled trials to investigate the effectiveness online depression treatment for young people with depressive complaints and the first to focus on an online group course.ObjectiveTo evaluate and discuss the effectiveness of a guided Web-based group course called Grip op Je Dip (Master Your Mood [MYM]), designed for young people aged 16 to 25 years with depressive symptoms, in comparison with a wait-listed control group.MethodsWe randomly assigned 244 young people with depressive symptoms to the online MYM course or to a waiting-list control condition. The primary outcome measure was treatment outcome after 3 months on the Center for Epidemiologic Studies Depression Scale. Secondary outcomes were anxiety (measured by the Hospital Anxiety and Depression Scale) and mastery (Mastery Scale). We studied the maintenance of effects in the MYM group 6 months after baseline. Missing data were imputed.ResultsThe MYM group (n = 121) showed significantly greater improvement in depressive symptoms at 3 months than the control group (n = 123) (t 187 = 6.62, P < .001), with a large between-group effect size of d = 0.94 (95% confidence interval [CI] 0.64–1.23). The MYM group also showed greater improvement in anxiety (t 187 = 3.80, P < .001, d = 0.49, 95% CI 0.24–0.75) and mastery (t 187 = 3.36, P = .001, d = 0.44, 95% CI 0.19–0.70). At 12 weeks, 56% (68/121) of the participants in the MYM group and 20% (24/123) in the control group showed reliable and clinically significant change. This between-group difference was significant (χ2 1 = 35.0, P < .001) and yielded a number needed to treat of 2.7. Improvements in the MYM group were maintained at 6 months. A limitation is the infeasibility of comparing the 6-month outcomes of the MYM and control groups, as the controls had access to MYM after 3 months.ConclusionsThe online group course MYM was effective in reducing depressive symptoms and anxiety and in increasing mastery in young people. These effects persisted in the MYM group at 6 months.Trial RegistrationNederlands Trial Register: NTR1694; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1694 (Archived by WebCite at http://www.webcitation.org/683SBoeGV)

Web-Based Interventions for Youth Internalizing Problems: A Systematic Review

“…MYM (www.gripopjedip.nl) is a Dutchlanguage, 6-session, therapist-assisted, CBTbased Internet program for youth with symptoms of depression. 29,30 In an open trial among adolescents with subclinical or mild depression, Gerrits et al 29 found a significant reduction in depressive symptoms at posttreatment. Approximately 36% of participants in the MYM group completed all sessions.…”

“…Approximately 36% of participants in the MYM group completed all sessions. Similarly, van der Zanden et al 30 randomized youth with subclinical and mild depression to MYM or a waitlist control (WLC) and found significantly greater improvement in depression among MYM participants than among WLC participants. This effect was large, and intervention gains were maintained in the MYM group at 6-month follow-up.…”

Feasibility of an Online Cognitive Behavioral–Based Group Intervention for Adolescents Treated for Cancer: A Pilot Study

“…The intervention appeared to be effective in reaching the target group and in reducing depressive symptoms and anxiety (Gerrits, van der Zanden, Visscher, & Conijn, 2007;van der Zanden, Kramer, Gerrits, & Cuijpers, 2012). Combining the technology and successful format of Master Your Mood Online with the content of the face-to-face OK Onco, an online cognitive behavioral-based group intervention for adolescent CCS was developed, called Op Koers Oncologie Online (OK Onco Online).…”

Online cognitive-based intervention for depression: exploring possible circularity in mechanisms of change

“…In addition to the limitations described in our previous publication on the randomized controlled trial of MYM (Van der Zanden et al 2012), the current study may have several other limitations. First, the absence of assessments during the course of the intervention prevented us from analysing the precise sequence of changes.…”

“…MYM has been shown effective in reducing depressive and anxiety symptoms and increasing mastery (Van der Zanden et al 2012). To explore the hypothesized circularity in the recovery process, we first analyse the relationship between depression and anxiety in our sample.…”