Individually tailored internet-based cognitive behaviour therapy for older adults with anxiety and depression: a randomised controlled trial

Silfvernagel, Kristin; Westlinder, Anna; Bergman, Kajsa C; Hernandez, Rosario Diaz; Fallhagen, Line; Lundqvist, Ida; Masri, Nicole; Viberg, Linda T.; Forsberg, Marie-Louise; Lind, Maria; Berger, Thomas; Carlbring, Per; Andersson, Gerhard

doi:10.1080/16506073.2017.1388276

Cited by 49 publications

(36 citation statements)

References 52 publications

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“…However, another study, conducted on 66 older adults with mixed anxiety depression randomized to ICBT or control conditions, who were administered the WCST (perseverative errors) and the Cognitive Failures Questionnaire before treatment, reported a moderate between‐group effect on the main outcome measure, the Beck Anxiety Inventory (d=0.50), favoring the treatment group. The authors concluded that the role of cognitive functioning in the outcome of ICBT should be further investigated.…”

Section: Mechanisms Of Change and Predictors Of Outcomementioning

confidence: 99%

Internet‐delivered psychological treatments: from innovation to implementation

et al. 2019

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Internet interventions, and in particular Internet-delivered cognitive behaviour therapy (ICBT), have existed for at least 20 years. Here we review the treatment approach and the evidence base, arguing that ICBT can be viewed as a vehicle for innovation. ICBT has been developed and tested for several psychiatric and somatic conditions, and direct comparative studies suggest that therapist-guided ICBT is more effective than a waiting list for anxiety disorders and depression, and tends to be as effective as face-to-face CBT. Studies on the possible harmful effects of ICBT are also reviewed: a significant minority of people do experience negative effects, although rates of deterioration appear similar to those reported for face-to-face treatments and lower than for control conditions. We further review studies on change mechanisms and conclude that few, if any, consistent moderators and mediators of change have been identified. A recent trend to focus on knowledge acquisition is considered, and a discussion on the possibilities and hurdles of implementing ICBT is presented. The latter includes findings suggesting that attitudes toward ICBT may not be as positive as when using modern information technology as an adjunct to face-to-face therapy (i.e., blended treatment). Finally, we discuss future directions, including the role played by technology and machine learning, blended treatment, adaptation of treatment for minorities and non-Western settings, other therapeutic approaches than ICBT (including Internet-delivered psychodynamic and interpersonal psychotherapy as well as acceptance and commitment therapy), emerging regulations, and the importance of reporting failed trials.

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Section: Mechanisms Of Change and Predictors Of Outcomementioning

confidence: 99%

Internet‐delivered psychological treatments: from innovation to implementation

et al. 2019

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“…This also saves time. However, sometimes we need to recruit participants in several waves and it is not always easy to recruit for example older persons ( Silfvernagel et al, 2018 ). But often the sample sizes tend to be around 80–120 participants, and one trend in ICBT research is to view smaller controlled trials as “pilots” ( Lundgren et al, 2016 ), instead of running small open trials as the pilot.…”

Section: Short-term Effectsmentioning

confidence: 99%

“…Third, cognitive function could potentially influence the outcome of internet interventions, for example in older adults, but also in persons with depression which is known to influence cognition ( Gotlib and Hammen, 2009 ). We have studied executive function in association with clinical trials and whereas most studies have shown no effects ( Andersson et al, 2008b ; Lindner et al, 2016 ), we did recently find an association between perseverative errors and negative outcome in a study on ICBT for older adults ( Silfvernagel et al, 2018 ).…”

Section: Predictors Of Outcome and Mechanisms Of Changementioning

confidence: 99%

Internet interventions: Past, present and future

Andersson¹

2018

Internet Interventions

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Internet interventions have been around now for about 20 years. While the field still suffers from a scattered terminology a large number of programs and studies exist. In the present paper I present an overview of my experiences of studying internet-supported cognitive-behaviour therapy (ICBT), but also mention other approaches including the use of smartphones. The paper covers the history of ICBT, short-term effects in controlled trials for a range of conditions, long-term effects, comparisons against face-to-face therapy, effectiveness studies, prediction studies, how the treatment is perceived, critique, and finally future directions. I conclude that we have now reached a stage in which we have numerous evidence-based treatments and procedures, and increasingly internet interventions including ICBT are disseminated.

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“…Both collaborative care, CGA and stepped-care models give attention to the complex multifactorial etiology of depressiveness. This is also the case in CBT in so called tailored interventions [118] and in augmentation strategies in pharmacology [119,120].…”

Section: Treatment Of Depressiveness In Very Old Personsmentioning

confidence: 98%

Subsyndromal Depression in Very Old Persons

Ludvigsson¹

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Background: Subsyndromal depression (SSD) or subthreshold depression is a common affective condition that can be described as depressiveness below the threshold of what is called a syndromal or a major depressive episode. The point prevalence for SSD has been reported to be about 10% in the community, or about two or three times higher than the prevalence for syndromal depression. In elderly persons, SSD compared to non-depression (ND) is associated with impaired activities of daily living (ADL), lower cognitive function, lower self-perceived health, worse psychiatric outcomes and higher mortality. However, most studies on SSD in elderly persons have been done in the young old age group (age 60-80 years), while few studies have investigated SSD in very old persons (age 80+). As many aspects (e.g. multimorbidity, frailty, functional decline and social dependence) increase between the young old and the very old ages, there is a need for more knowledge about SSD in the very old. The overall aim of this doctoral thesis was to describe SSD, or the unclear area between syndromal depression and normal aging, in very old persons. Method: Paper 1 was based on qualitative interviews (n=27), while papers 2-4 were based largely on data from a prospective observational cohort study "Elderly in Linköping Screening Assessment" (ELSA85), with a population-based design following the participants from the age of 85 in three waves of follow-up. The 15-item Geriatric Depression Scale (GDS-15) was used for measuring depressiveness and to define SSD in the studies. Results: The analysis of the qualitative interviews (paper 1) resulted in four themes (life curve and the body go down, to manage on one's own, to keep up with life, and taking one day at a time), giving a comprehensive picture of SSD in very old age. In a comparison among SSD, ND and syndromal depression, SSD differed qualitatively from syndromal depression, but not clearly from ND. A cross-sectional analysis of data from baseline (paper 2) identified factors associated with SSD in very old persons, and according to analyses with multiple logistic and linear regressions, four domains (sociodemographic factors, declining physical functioning, neuropsychiatric factors, and existential factors) were significantly associated with SSD. A five-year longitudinal follow-up (paper 3) showed that direct healthcare costs per month of survival for persons with SSD exceeded those of persons with ND by a ratio of 1.45 (€634 vs €436), a difference that was significant even after controlling for somatic multimorbidity. An eight-year longitudinal follow-up (paper 4) showed that morbidity was elevated for persons with SSD compared to ND regarding basic ADL, I-ADL, loneliness, self-perceived health and depressiveness, whereas cognitive speed, executive functions and global cognitive function were not significantly lower when adjusting for covariates. Contrary to our hypotheses, mortality over

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Individually tailored internet-based cognitive behaviour therapy for older adults with anxiety and depression: a randomised controlled trial

Cited by 49 publications

References 52 publications

Internet‐delivered psychological treatments: from innovation to implementation

Internet‐delivered psychological treatments: from innovation to implementation

Internet interventions: Past, present and future

Subsyndromal Depression in Very Old Persons

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