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David Baxter

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Brief internet-based depression interventions show long-term benefits
By Liam Davenport
22 February 2008
Br J Psychiatry 2008; 192: 130-134

Brief internet-based interventions appear to have benefits for patients with depression that last beyond the intervention itself, potentially up to 12 months later, Australian study findings indicate.

Previous studies of brief cognitive-behavioral therapy (CBT) programs delivered over the internet have indicated that they may be effective in reducing depression. However, the effects of such interventions have largely not been examined beyond the end of the intervention.

Building on their results from a study in which 525 community individuals with elevated depression scores were assigned to a CBT internet intervention, a depression information website, or a placebo control, Andrew Mackinnon and colleagues from the Australian National University in Canberra examined 6- and 12-month follow-up data.

In all, 79% of the original participants completed their assigned intervention, and 60% were retained at the 12-month follow-up. CBT and depression website participants were more likely to withdraw than controls, at odds ratios of 4.70 and 2.45, respectively. Among patients in the control group, only those with higher pre-test Center for Epidemiological Studies - Depression (CES-D) scores were more likely to withdraw, at an odds ratio of 1.07 per CES-D unit compared with patient with low scores.

Among participants assigned to online CBT, CES-D scores fell from 21.8 at the pre-test measure to 15.9 at the post-test measure, 15.6 at 6 months, and 14.1 at 12 months. Respective CES-D scores for participants assigned to the depression website or the control intervention were 21.1 versus 21.6, 16.2 versus 19.5, 15.1 versus 17.8, and 12.6 versus 16.4.

Both the online CBT and depression website interventions significantly reduced CDS-D scores at the post-test measure in comparison with the control intervention, at average relative reductions of 4.3 points and 3.2 points, respectively.

At 6 months, only the CBT intervention maintained a significant advantage over the control, although, at 12 months, both active interventions were once again significantly better than the control intervention.

The team says in the British Journal of Psychiatry: "This study provides some evidence that the effects on depressive symptomatology of an internet-based CBT and an information-based intervention persist beyond those recorded at treatment cessation."

They add: "Further community research should investigate the circumstances under which these interventions prevent or reduce symptoms, reduce stigma, increase help-seeking, maintain treatment participation, and offer knowledge and self-help that is sought and of value to individuals."

Abstract
 

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