Internet-based self-help for depression: randomised controlled trial

Andersson, Gerhard; Bergström, Jan; Holländare, Fredrik; Carlbring, Per; Kaldo, Viktor; Ekselius, Lisa

doi:10.1192/bjp.187.5.456

Cited by 440 publications

(353 citation statements)

References 19 publications

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“…Two studies on internet-based treatment for depression with very similar designs also obtained post-treatment data for 66% of participants (Clarke et al 2002(Clarke et al , 2005. A study with a follow-up period of 6 weeks obtained posttreatment data for 83 % of participants (Christensen et al 2004), and a study on an intervention that included therapist assistance obtained post-treatment data for 73 % of participants (Andersson et al 2005). There is only one study on minimal contact internet-based interventions for depression in which an extremely low drop-out rate has been observed (3 %), but the way that drop-out was defined was not clearly mentioned (Patten, 2003).…”

Section: Discussionmentioning

confidence: 99%

Internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years old: a randomized controlled clinical trial

et al. 2007

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Background. Subthreshold depression is a highly prevalent condition and a risk factor for developing a major depressive episode. Internet-based cognitive behaviour therapy may be a promising approach for the treatment of subthreshold depression. The current study had two aims :(1) to determine whether an internet-based cognitive behaviour therapy intervention and a group cognitive behaviour therapy intervention are more effective than a waiting-list control group ; and (2) to determine whether the effect of the internet-based cognitive behaviour therapy differs from the group cognitive behaviour therapy intervention.

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Section: Discussionmentioning

confidence: 99%

Internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years old: a randomized controlled clinical trial

et al. 2007

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“…20 Support provided by health professionals in the Internet studies included in our review varied. Approaches included therapist feedback but no face-to-face contact, 51,57,62 minimal therapist interaction by email, 29,50 and no therapist interaction, 53,65 though with provision of reminders, 31 or instruction on use of websites. 30 The Internet gives the opportunity to provide interventions for some conditions with little or no support, though the appropriate level of therapist interaction for particular applications requires further study.…”

Section: Discussionmentioning

confidence: 99%

“…Three high-or good-quality Internet studies showed TMH to be successful, with follow-up work needed for one, and desirable for another. [29][30][31] Six of 8 studies that used telephone-based approaches showed TMH to be successful, but with a need for follow-up study. [32][33][34][35][36][37][38] One study indicated TMH was unsuccessful, 39 and results from another were unclear.…”

Section: General Psychiatric and Mental Health Servicesmentioning

confidence: 99%

The Effectiveness of Telemental Health Applications: A Review

2008

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Objective: To review the evidence of benefit from use of telemental health (TMH) in studies that reported clinical or administrative outcomes.Method: Relevant publications were identified through computerized literature searches using several electronic databases. Included for review were scientifically valid articles that described controlled studies, comparing TMH with a non-TMH alternative, and uncontrolled studies that had no fewer than 20 participants. Quality of the evidence was assessed with an approach that considers both study performance and study design. Judgments were made on whether further data were needed to establish each TMH application as suitable for routine clinical use.Results: Included in the review were 72 papers that described 65 clinical studies; 32 (49%) studies were of high or good quality. Quality of evidence was higher for Internet-and telephone-based interventions than for video conferencing approaches. There was evidence of success with TMH in the areas of child psychiatry, depression, dementia, schizophrenia, suicide prevention, posttraumatic stress, panic disorders, substance abuse, eating disorders, and smoking prevention. Evidence of success for general TMH programs and in the management of obsessive-compulsive disorder were less convincing. Further study was judged to be necessary or desirable in 53 (82%) of the studies. Conclusion:Evidence of benefit from TMH applications is encouraging, though still limited. There is a need for more good-quality studies on the use of TMH in routine care. The emerging use of Internet-based applications is an important development that deserves further evaluation. Can J Psychiatry 2008;53(11):769-778 Clinical Implications· There is encouraging evidence of the successful use of TMH in several applications. However, further work to establish its suitability in routine practice is desirable. · Internet-based approaches to TMH are likely to increase in importance. Limitations· The evidence base for TMH outcomes remains small. · Assessment of quality is based in part on subjective judgments on study attributes. · Findings on TMH success and need for further study are based on published material and do not necessarily reflect specific clinical experience.

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“…The results for mood disorder was lower (d ¼ 0.32), but this was probably due to the fact that studies with no therapist support and no proper diagnostic assessment lowered the effect size. One study from Sweden was regarded as an outlier, because it had effects more similar to those found in the studies on anxiety disorders with a between-group Cohen's d of 0.90 (Andersson et al, 2005).…”

Section: Brief Review Of the Evidencementioning

confidence: 99%