Internet-Based Cognitive Behavior Therapy Only for the Young? A Secondary Analysis of a Randomized Controlled Trial of Depression Treatment

Abstract

Background: Late-life depression is a major public health concern, driving the development of complementary treatment options. This study investigates the effectiveness and acceptability of internet-based Cognitive Behavioral Therapy (iCBT) in older individuals (60+ years) compared to younger age groups. Materials and Methods: Secondary analysis of a cluster-randomized controlled trial with 647 (18-82 years; mean 43.9) mild to moderately severe depressed primary care patients receiving either iCBT + treatment as usual (TAU) or TAU alone. Severity of depression was measured by the Beck Depression Inventory (BDI-II) at baseline, 6 weeks and 6 months. Intention-to-treat analysis in three age groups (18-39 years, n = 264; 40-59 years, n = 300; 60+ years, n = 83) was performed, using mixed-effects regression models to quantify treatment effect. Results: No age differences in the effectiveness of iCBT were found. Patients in the intervention group consistently showed a greater reduction in depression severity than controls in all three age groups and at both follow-ups. Effect sizes ranged from d = 0.30 (40-59 years, 6 weeks) to d = 1.91 (60+ years, 6 months). Uptake of the intervention was banded around 70% with no differences between age groups (c² = 0.18, p = .915). The mean number of completed modules increased with age (c² = 18.99, p = .040). Discussion: iCBT is equally effective in both younger and older individuals, thus providing a valuable complementary element of routine late-life depression care.

What Builds Resilience? Sociodemographic and Social Correlates in the Population-Based LIFE-Adult-Study

“…Sociodemographic information included age, gender, educational and vocational qualification, marital status, and occupation. We summarized participants in three age groups (26–39 years, 40–59 years, and ≥60 years) according to Pabst et al [ 31 ] to generate data on resilience according to age. Information on educational and vocational qualifications was classified into low, middle, and high education according to the Comparative Analysis of Social Mobility in Industrial Nations (CASMIN) educational classification [ 32 ].…”

What Comes after the Trial? An Observational Study of the Real-World Uptake of an E-Mental Health Intervention by General Practitioners to Reduce Depressive Symptoms in Their Patients

“…The present observational cross-sectional study presents quantitative data derived from a spin-off GP survey about 2.5 years subsequent to @ktiv trial. The study design and results of the preceding @ktiv trial have been described elsewhere [14,15,23,27]. Within the trial, N = 647 GP patients were recruited via N = 112 GP practices in central Germany.…”

“…Electronic mental (e-mental) health involves digital interventions leveraging the Internet and related technologies, such as smartphone apps, websites, virtual reality-based interventions, or social media, to deliver mental health services, in order to promote and to improve mental health [8][9][10][11]. Even though effect sizes have been reported to be higher in guided interventions [12], unguided interventions have also been proven to be effective and are viable treatment and self-help options [13][14][15][16][17]. According to a new individual participant data (IPD) network meta-analysis, unguided Internet-based cognitive behavioral therapy (iCBT) is just as effective in improving depressive symptoms among individuals with mild and subthreshold depression as guided iCBT [17].…”

Internet-Based Psychotherapy Intervention for Depression Among Older Adults Receiving Home Care: Qualitative Study of Participants’ Experiences

“…An emerging body of research also suggests that iCBT is acceptable and potentially effective in reducing depressive symptoms in later life [ 9 ]. In addition, a recent randomized controlled trial reported no significant age-related differences in iCBT effectiveness [ 10 ].…”