Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation.
rct · Level II
Where this comes from
- Record sourced from PubMed, PMID 32213470.
- Also identified by DOI 10.2196/15312 and PMC identifier 7146239.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Web-based interventions have been shown to be effective for the treatment of depression. However, interventions are often complex and include a variety of elements, making it difficult to identify the most effective component(s). The aim of this pilot study was to shed light on mechanisms in the online treatment of depression by comparing a single-module, fully automated intervention for depression (internet-based behavioral activation [iBA]) to a nonoverlapping active control intervention and a nonactive control group. We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, >4) via the internet at baseline (t<sub>0</sub>) and 2 weeks (t<sub>1</sub>) and 4 weeks (t<sub>2</sub>) later. After the t<sub>0</sub> assessment, participants were randomly allocated to one of three groups: (1) iBA (n=37), (2) active control using a brief internet-based mindfulness intervention (iMBI, n=32), or (3) care as usual (CAU, n=35). The primary outcome was improvement in depressive symptoms, as measured using the Patient Health Questionnaire-9. Secondary parameters included changes in activity, dysfunctional attitudes, and quality of life. While groups did not differ regarding the change in depression from t<sub>0</sub> to t<sub>1</sub> (η<sub>p</sub><sup>2</sup>=.007, P=.746) or t<sub>0</sub> to t<sub>2</sub> (η<sub>p</sub><sup>2</sup>=.008, P=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t<sub>0</sub> to t<sub>2</sub> in comparison to CAU (η<sub>p</sub><sup>2</sup>=.053, P=.04) and a larger increase in activity from t<sub>0</sub> to t<sub>1</sub> than the pooled control groups (η<sub>p</sub><sup>2</sup>=.060, P=.02). A change in depression from t<sub>0</sub> to t<sub>2</sub> was mediated by a change in activity from t<sub>0</sub> to t<sub>1</sub>. At t<sub>1</sub>, 22% (6/27) of the participants in the iBA group and 12% (3/25) of the participants in the iMBI group indicated that they did not use the intervention. Although we did not find support for the short-term efficacy of the single-module iBA regarding depression, long-term effects are still conceivable, potentially initiated by changes in secondary outcomes. Future studies should use a longer intervention and follow-up interval. DKRS (#DRKS00011562).
Medical subject headings
- Depression
- Internet-Based Intervention
- Quality of Life