Effectiveness of guided Internet-delivered treatment for major depression in routine mental healthcare - An open study

Abstract

Depression is one of the most prevalent mental health disorders and is estimated to become the leading cause of disability worldwide by 2030. Increasing access to effective treatment for depression is a major societal challenge. In this context, the increasing use of computers in the form of laptops or smartphones has made it feasible to increase access to mental healthcare through digital technology. In this study, we examined the effectiveness of a 14-week therapist-guided Internet-delivered program for patients with major depression undergoing routine care. From 2015 to 2018, 105 patients were included in the study. For depressive symptoms, we identified significant within-group effect sizes (post-treatment: d = 0.96; 6-month follow-up: d = 1.21). We also found significant effects on secondary anxiety and insomnia symptoms (d = 0.55–0.92). Clinically reliable improvement was reported by 48% of those undergoing the main parts of the treatment, whereas 5% of the participants reported a clinically significant deterioration. However, a large proportion of patients showed no clinically reliable change. In summary, the study identified large treatment effects, but also highlighted room for improvement in the usability of the treatment.

A Comparison of Self-Referral and Referral via Primary Care Providers, through Two Similar Digital Mental Health Services in Western Australia

“…Clinical deterioration on the K-10 was less than 3% for both clinics, and patient satisfaction was high. These outcomes are consistent with previous reports [ 24 , 25 ], and compare favorably with outcomes from other DMHSs that offer online treatment as part of routine care in public health systems around the world [ 46 , 47 , 48 , 49 , 50 , 51 ].…”

Factors associated with treatment uptake, completion, and subsequent symptom improvement in a national digital mental health service

“…The clinical outcomes of psychological interventions such as internet-delivered cognitive behavioural therapy (iCBT) have been shown to be equivalent to high quality face-to-face psychological interventions ( Carlbring et al, 2018 ). DMHS already provide treatment as part of routine care in several countries ( Titov et al, 2019a ; Titov et al, 2018 ) ( Hadjistavropoulos et al, 2021 ; Nordgreen et al, 2019 ; Titov et al, 2019b ; Ruwaard et al, 2012 ; Johansson et al, 2019 ; Staples et al, 2021 ).…”

Experiences of a therapist-guided internet-delivered intervention for hazardous and harmful drinking. A qualitative study

“…Principles from MI were implemented at the beginning of the program and among other things, participants were asked to think about the pros and cons of drinking alcohol and why they wanted to change drinking habits. Furthermore, the intervention was inspired by ICBT interventions for anxiety and depression tested in clinical trials in Norway and later implemented in the health services ( Nordgreen et al, 2018 ; Nordgreen et al, 2019 ). The ICBT consisted of nine modules distributed over nine weeks ( Table 2 ).…”