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Comparative randomised trial of online cognitive–behavioural therapy and an information website for depression: 12-month outcomes

Published online by Cambridge University Press:  02 January 2018

Andrew Mackinnon*
Affiliation:
Centre for Mental Health Research, The Australian National University, Canberra, Australia
Kathleen M. Griffiths
Affiliation:
Centre for Mental Health Research, The Australian National University, Canberra, Australia
Helen Christensen
Affiliation:
Centre for Mental Health Research, The Australian National University, Canberra, Australia
*
Andrew Mackinnon, Centre for Mental Health Research, The Australian National University, Canberra, ACT, 0200, Australia. Email: [email protected]
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Abstract

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Background

An earlier paper reported positive outcomes immediately following access to a cognitive–behavioural therapy (CBT) internet intervention and a depression information website.

Aims

To determine 6-month and 12-month outcomes of the interventions relative to a placebo control condition.

Method

Participants allocated to the depression information website condition, the CBT internet intervention and the placebo control condition were followed up at 6 and 12 months by survey. The primary outcome measure was the Center for Epidemiologic Studies – Depression (CES–D) scale. Of 525 participants recruited, 79% completed their assigned intervention and 60% were retained at 12-month follow-up. Attrition was handled using mixed-model repeated-measures ANOVA.

Results

Both the CBT site and depression information sites were associated with statistically significant benefits in CES–D score reduction compared with controls at post-test. At 6-months follow-up, the reduction seen for the people allocated to the CBT arm remained significant, whereas that for the depression information website arm was not. At 12 months, both active interventions were statistically significantly superior to the control condition.

Conclusions

There is some evidence that benefits of these brief internet interventions are retained beyond their endpoint. The impact of human support provided by interviewers in the trial must be considered when comparing these outcomes to routine use of both internet interventions.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 2008 

References

1 Christensen, H, Griffiths, KM, Jorm, AF. Delivering interventions for depression by using the internet: randomised controlled trial. BMJ 2004; 328: 265–9.CrossRefGoogle ScholarPubMed
2 Clarke, G, Reid, E, Eubanks, D, O'Connor, E, DeBar, LL, Kelleher, C, Lynch, F, Nunley, S. Overcoming depression on the internet (ODIN): a randomised controlled trial of an internet depression skills intervention program. J Med Internet Res 2002; 4: e14.CrossRefGoogle Scholar
3 Emmelkamp, PM. Technological innovations in clinical assessment and psychotherapy. Psychother Psychosom 2005; 74: 336–43.CrossRefGoogle ScholarPubMed
4 Spek, V, Cuijpers, P, Nyklícek, I, Riper, H, Keyzer, J, Pop, V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med 2007; 37: 319–28.CrossRefGoogle ScholarPubMed
5 Christensen, H, Mackinnon, AJ. The law of attrition revisited. J Med Internet Res 2006; 8: e20.CrossRefGoogle ScholarPubMed
6 Eysenbach, G. The law of attrition. J Med Internet Res 2005; 7: e11.CrossRefGoogle ScholarPubMed
7 Houck, PR, Mazumdar, S, Koru-Sengul, T, Tang, G, Mulsant, BH, Pollock, BG, Reynolds, CF 3rd. Estimating treatment effects from longitudinal clinical trial data with missing values: comparative analyses using different methods. Psychiatry Res 2004; 129: 209–15.CrossRefGoogle ScholarPubMed
8 Little, R, Yau, L. Intent-to-treat analysis for longitudinal studies with drop-outs. Biometrics 1996; 52: 1324–33.CrossRefGoogle ScholarPubMed
9 Pickles, A, Everitt, B. Statistical Aspects of the Design and Analysis of Clinical Trials. Imperial College Press, 2005.Google Scholar
10 Salim, A, Mackinnon, A, Christensen, H, Griffiths, K. Comparison of data analysis strategies for assessing treatment effectiveness in pretest-posttest designs with substantial dropout rates. Psychiatry Res 2007. In press.CrossRefGoogle Scholar
11 Radloff, LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385401.CrossRefGoogle Scholar
12 Gueorguieva, R, Krystal, JH. Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Arch Gen Psychiatry 2004; 61: 310–17.CrossRefGoogle ScholarPubMed
13 SAS Institute Inc. SAS/STAT Release 9.1. SAS Institute Inc., 2003.Google Scholar
14 Christensen, H, Griffiths, KM, Mackinnon, AJ, Brittliffe, K. Online randomized controlled trial of brief and full cognitive behavior therapy for depression. Psychol Med 2006; 36: 1737–46.CrossRefGoogle ScholarPubMed
15 Christensen, H, Leach, LS, Barney, L, Mackinnon, AJ, Griffiths, KM. The effect of web based depression interventions on self reported help seeking: randomised controlled trial [ISRCTN77824516]. BMC Psychiatry 2006; 6: 13.CrossRefGoogle ScholarPubMed
16 Atherton-Naji, A, Hamilton, R, Riddle, W, Naji, S. Improving adherence to antidepressant drug treatment in primary care: a feasibility study for a randomized controlled trial of educational intervention. Prim Care Community Psychiatr 2001; 7: 61–7.Google Scholar
17 Jorm, AF, Griffiths, KM, Christensen, H, Korten, AE, Parslow, RA, Rodgers, B. Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms. Psychol Med 2003; 33: 1071–9.CrossRefGoogle ScholarPubMed
18 Mundt, JC, Clarke, GN, Burroughs, D, Brenneman, DO, Griest, JH. Effectiveness of antidepressant pharmacotherapy: the impact of medication compliance and patient education. Depress Anxiety 2001; 13: 110.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
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