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A computer-assisted depression intervention in primary care

Published online by Cambridge University Press:  20 October 2010

W. Levin ,
D. R. Campbell ,
K. B. McGovern ,
J. M. Gau ,
D. B. Kosty ,
J. R. Seeley  and
P. M. Lewinsohn
W. Levin*
Affiliation:
mPower, LLC, Eugene, Oregon, USA
D. R. Campbell
Affiliation:
mPower, LLC, Eugene, Oregon, USA
K. B. McGovern
Affiliation:
mPower, LLC, Eugene, Oregon, USA
J. M. Gau
Affiliation:
Abacus Research, Eugene, Oregon, USA
D. B. Kosty
Affiliation:
Oregon Research Institute, Eugene, Oregon, USA
J. R. Seeley
Affiliation:
Oregon Research Institute, Eugene, Oregon, USA
P. M. Lewinsohn
Affiliation:
Oregon Research Institute, Eugene, Oregon, USA
*
*Address for correspondence: W. Levin, Ph.D., mPower, LLC, 2039 Harris Street, Eugene, OR 97405, USA. (Email: [email protected])
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Abstract

Background

The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial.

Method

A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention.

Results

Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants.

Conclusions

The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact, ⩽5 min from a psychologist 2 weeks after receiving the program). Overall, the findings add support to the accumulating evidence for the potential clinical benefit of computer-assisted behavioral health interventions.

Keywords

Cognitive-behavioural therapycomputer-assisted interventiondepressionprimary careself-help
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 7 , July 2011 , pp. 1373 - 1383
Copyright
Copyright © Cambridge University Press 2010

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