23 Feb Self-Guided Internet Based Cognitive Behavioral Therapy Shows Promise For Depression
MedicalResearch.com Interview with:
Eirini Karyotaki, MSc
Department of Clinical Psychology and EMGO Institute for Health and Care Research
Vrije Universiteit Amsterdam
Amsterdam, the Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Depression is broadly acknowledged as a major health issue associated with a great risk of mortality and morbidity. Nevertheless, help-seeking rates are low among individuals with depression. Some of the barriers that impede help seeking are the limited availability of trained clinicians, the fear of stigmatisation and the cost of treatment. Self-guided Internet based Cognitive behavioural therapy (iCBT) has the potential to overcome many of these treatment barriers. However, recent randomised controlled trials (RCTs) have produced mixed evidence regarding the effects of self-guided iCBT in treating adults with depressive symptoms.
To gain more insight in the effectiveness of self-guided iCBT, an Individual Participant Data meta-analysis was performed. 3876 individual participant data across 13 RCTs were collected and analysed.
MedicalResearch.com: What should readers take away from your report?
Response: Results indicated that self-guided iCBT produces a small but significant effect in treating depressive symptoms compared to non-active control conditions, while the more online sessions a participant completes the greater the reduction in depressive symptoms. These results were unlikely to be influenced by participant and clinical characteristics, such as age, gender, and comorbid anxiety.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should focus on ways to maximise treatment adherence, long-term outcomes, the added value of therapist support and on the pragmatic effectiveness of self-guided iCBT in routine care setting.
MedicalResearch.com: Is there anything else you would like to add?
Response: Self-guided iCBT produces promising results although small in magnitude and it can be considered as a first step treatment approach for adult depression. This small effect can still be clinically relevant given that the mental health care in low- and middle income countries is limited. When self-guided iCBT is disseminated worldwide, the overall impact can be high, because of the large numbers of people that can be reached with it.
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Karyotaki E, Riper H, Twisk J, Hoogendoorn A, Kleiboer A, Mira A, Mackinnon A, Meyer B, Botella C, Littlewood E, Andersson G, Christensen H, Klein JP, Schröder J, Bretón-López J, Scheider J, Griffiths K, Farrer L, Huibers MJH, Phillips R, Gilbody S, Moritz S, Berger T, Pop V, Spek V, Cuijpers P. Efficacy of Self-guided Internet-Based Cognitive Behavioral Therapy in the Treatment of Depressive SymptomsA Meta-analysis of Individual Participant Data . JAMA Psychiatry. Published online February 22, 2017. doi:10.1001/jamapsychiatry.2017.0044
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