Efficacy and cost-effectiveness of guided and unguided internet- and mobile-based indicated transdiagnostic prevention of depression and anxiety (ICare Prevent): A three-armed randomized controlled trial in four European countries

Weisel, Kiona K.; Zarski, Anna-Carlotta; Berger, Thomas; Krieger, Tobias; Schaub, Michael P; Moser, Christian; Berking, Matthias; Dey, Michelle; Botella, Cristina; Baños, Rosa M.; Herrero, Rocío; Etchemendy, Ernestina; Riper, Heleen; Cuijpers, Pim; Bolinski, Felix; Kleiboer, Annet; Görlich, Dennis; Beecham, Jennifer; Jacobi, Corinna; Ebert, David Daniel

doi:10.1016/j.invent.2018.04.002

Cited by 50 publications

(51 citation statements)

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“…Due to high comorbidity rates between emotional disorders (Beekman et al, 2000) and overlapping risk factors (de Graaf, Bijl, Smit, Vollebergh, & Spijker, 2002), such studies should also explore relative advantages of disorder versus transdiagnostic and individual tailored preventive interventions (Weisel et al, 2018). However, this does not imply that students at lower risk do not warrant preventive interventions.…”

Section: Implications For Clinical Practice and Future Researchmentioning

confidence: 99%

“…More research is needed to obtain information on the needs of students who are associated with different risk levels and which interventions work best at varying levels. Due to high comorbidity rates between emotional disorders (Beekman et al, 2000) and overlapping risk factors (de Graaf, Bijl, Smit, Vollebergh, & Spijker, 2002), such studies should also explore relative advantages of disorder versus transdiagnostic and individual tailored preventive interventions (Weisel et al, 2018). In contrast, targeting students who experience any childhoodadolescent trauma, such as emotional abuse, could have a beneficiary effect for about one third of subsequent depression onsets.…”

Section: Implications For Clinical Practice and Future Researchmentioning

confidence: 99%

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Prediction of major depressive disorder onset in college students

et al. 2018

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Background Major depressive disorder (MDD) in college students is associated with substantial burden. Aims To assess 1‐year incidence of MDD among incoming freshmen and predictors of MDD‐incidence in a representative sample of students. Method Prospective cohort study of first‐year college students (baseline: n = 2,519, 1‐year follow‐up: n = 958) Results The incidence of MDD within the first year of college was 6.9% (SE = 0.8). The most important individual‐level predictors of onset were prior suicide plans and/or attempts (OR = 9.5). The strongest population‐level baseline predictors were history of childhood–adolescent trauma, stressful experience in the past 12 months, parental psychopathology, and other 12‐month mental disorder. Multivariate cross‐validated prediction (cross‐validated AUC = 0.73) suggest that 36.1% of incident MDD cases in a replication sample would occur among the 10% of students at highest predicted risk (24.5% predicted incidence in this highest‐risk subgroup). Conclusions Screening at college entrance is a promising strategy to identify students at risk of MDD onset, which may improve the development and deployment of targeted preventive interventions.

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Section: Implications For Clinical Practice and Future Researchmentioning

confidence: 99%

Section: Implications For Clinical Practice and Future Researchmentioning

confidence: 99%

Prediction of major depressive disorder onset in college students

et al. 2018

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“…The efficacy of these interventions can be enhanced by therapist support, although this effect may be smaller than previously thought (eg, standardized mean difference symptoms = 0.27 [ 18 - 20 ]). The high prevalence of depression and the ubiquity of internet access and mobile phone ownership make self-guided iCBTs hugely promising in reducing the burden of disability associated with depressive symptoms, even if they were somewhat less effective than guided iCBTs [ 21 ]. Kazdin and Blase [ 3 ] have called attention to the fact that the number of individuals with mental disorders such as depression far outnumbers the number of mental health providers available to deliver treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Kazdin and Blase [ 3 ] have called attention to the fact that the number of individuals with mental disorders such as depression far outnumbers the number of mental health providers available to deliver treatment. Thus, self-guided iCBT has the potential for a greater public health impact than guided iCBT or other forms of treatment that require contact with a trained professional [ 21 ]. However, a key concern in evaluating the self-guided iCBT treatment literature is the degree to which the patient population in randomized controlled trials (RCTs) is representative of the heterogeneous nature of the prognosis, severity, and comorbidity found in depressed patients.…”

Section: Introductionmentioning

confidence: 99%

The Generalizability of Randomized Controlled Trials of Self-Guided Internet-Based Cognitive Behavioral Therapy for Depressive Symptoms: Systematic Review and Meta-Regression Analysis

Lorenzo‐Luaces¹,

Johns²,

Keefe³

2018

J Med Internet Res

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BackgroundSelf-guided internet-based cognitive behavioral therapies (iCBTs) for depressive symptoms may substantially increase accessibility to mental health treatment. Despite this, questions remain as to the generalizability of the research on self-guided iCBT.ObjectiveWe sought to describe the clinical entry criteria used in studies of self-guided iCBT, explore the criteria’s effects on study outcomes, and compare the frequency of use of these criteria with their use in studies of face-to-face psychotherapy and antidepressant medications. We hypothesized that self-guided iCBT studies would use more stringent criteria that would bias the sample toward those with a less complex clinical profile, thus inflating treatment outcomes.MethodsWe updated a recently published meta-analysis by conducting a systematic literature search in PubMed, MEDLINE, PsycINFO, and EMBASE. We conducted a meta-regression analysis to test the effect of the different commonly used psychiatric entry criteria on the treatment-control differences. We also compared the frequency with which exclusion criteria were used in the self-guided iCBT studies versus studies of face-to-face psychotherapy and antidepressants from a recently published review.ResultsOur search yielded 5 additional studies, which we added to the 16 studies identified by Karyotaki and colleagues in 2017. Few self-guided iCBT studies excluded patients with severe depressive symptoms (6/21, 29%), but self-guided iCBT studies were more likely than antidepressant (14/170, 8.2%) studies to use this criterion. However, self-guided iCBT studies did not use this criterion more frequently than face-to-face psychotherapy studies (6/16, 38%). Beyond this, we found no evidence that self-guided iCBTs used more stringent entry criteria. Strong evidence suggested that they were actually less likely to use most entry criteria, especially exclusions on the basis of substance use or personality pathology. None of the entry criteria used had an effect on outcomes.ConclusionsA conservative interpretation of our findings is that the patient population sampled in the literature on self-guided iCBT is relatively comparable with that of studies of antidepressants or face-to-face psychotherapy. Alternatively, studies of unguided cognitive behavioral therapy may sample from a more heterogeneous and representative patient population. Until evidence emerges to suggest otherwise, the patient population sampled in self-guided iCBT studies cannot be considered as less complex than the patient population from face-to-face psychotherapy or antidepressant studies.

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“…The TiC-P has been proven to be a feasible and reliable instrument for measuring healthcare utilization and productivity loss (55). The German adaption has been utilized in a substantial number of randomized controlled trials as a basis for health economic outcome evaluations (56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67).…”

Section: Costs Associated With Psychiatric Illnessmentioning

confidence: 99%

Design of a Guided Internet- and Mobile-Based Intervention for Internet Use Disorder—Study Protocol for a Two-Armed Randomized Controlled Trial

et al. 2020

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Context: Internet Use Disorder (IUD), characterized as the inability to control one's internet use, is emerging as an increasing societal concern as it is associated with reduced quality of life and mental health comorbidities. Evidence-based treatment options are, however, scarce due to the novelty of the diagnosis. Internet-and mobile-based interventions may be an effective means to deliver psychological treatment to individuals with IUD as they address individuals affected in their online setting. The aim of the study is to evaluate the efficacy of a newly developed, guided internet-and mobile-based intervention for IUD. Methods: In a two-armed randomized controlled trial (N = 130), individuals showing problematic internet use patterns (Internet Addiction Test ≥ 49) will be randomly allocated to the internet-and mobile-based intervention or a waiting control group. Assessments will take place at baseline, 7 weeks, 6-and 12 months after randomization. The primary outcome is internet addiction symptom severity (IAT) at 7 weeks. Secondary outcomes include quality of life, depressive symptoms, anxiety, and other psychosocial variables associated with IUD. Intervention: The intervention consists of seven sessions: Goal setting and motivational interviewing, impulse control, problem solving, cognitive restructuring, self-worth, relapse prevention, and a booster session. Participants are supported by an eCoach who provides individual feedback after completion of each session. Participants can choose between several elective sessions based on individual need. Conclusions: This is the first study to evaluate an internet-and mobile-based intervention for IUD, which could be a promising first step to reduce individuals' disease burden. Trial Registration: DRKS00015314. The study is currently ongoing. First participants were enrolled in the study on September 14th 2018. Recruitment will continue approximately through March 2020.

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Efficacy and cost-effectiveness of guided and unguided internet- and mobile-based indicated transdiagnostic prevention of depression and anxiety (ICare Prevent): A three-armed randomized controlled trial in four European countries

Cited by 50 publications

References 120 publications

Prediction of major depressive disorder onset in college students

Prediction of major depressive disorder onset in college students

The Generalizability of Randomized Controlled Trials of Self-Guided Internet-Based Cognitive Behavioral Therapy for Depressive Symptoms: Systematic Review and Meta-Regression Analysis

Design of a Guided Internet- and Mobile-Based Intervention for Internet Use Disorder—Study Protocol for a Two-Armed Randomized Controlled Trial

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