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Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis

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Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. / Karyotaki, Eirini; Kemmeren, Lise; Riper, Heleen; Twisk, Jos; Hoogendoorn, Adriaan; Kleiboer, Annet; Mira, Adriana; Mackinnon, Andrew; Meyer, Björn; Botella, Cristina; Littlewood, Elizabeth; Andersson, Gerhard; Christensen, Helen; Klein, Jan P; Schröder, Johanna; Bretón-López, Juana; Scheider, Justine; Griffiths, Kathy; Farrer, Louise; Huibers, Marcus J H; Phillips, Rachel; Gilbody, Simon; Moritz, Steffen; Berger, Thomas; Pop, Victor; Spek, Viola; Cuijpers, Pim.

in: PSYCHOL MED, Jahrgang 48, Nr. 15, 11.2018, S. 2456-2466.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung

Harvard

Karyotaki, E, Kemmeren, L, Riper, H, Twisk, J, Hoogendoorn, A, Kleiboer, A, Mira, A, Mackinnon, A, Meyer, B, Botella, C, Littlewood, E, Andersson, G, Christensen, H, Klein, JP, Schröder, J, Bretón-López, J, Scheider, J, Griffiths, K, Farrer, L, Huibers, MJH, Phillips, R, Gilbody, S, Moritz, S, Berger, T, Pop, V, Spek, V & Cuijpers, P 2018, 'Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis', PSYCHOL MED, Jg. 48, Nr. 15, S. 2456-2466. https://doi.org/10.1017/S0033291718000648

APA

Karyotaki, E., Kemmeren, L., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A., Mackinnon, A., Meyer, B., Botella, C., Littlewood, E., Andersson, G., Christensen, H., Klein, J. P., Schröder, J., Bretón-López, J., Scheider, J., Griffiths, K., Farrer, L., ... Cuijpers, P. (2018). Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. PSYCHOL MED, 48(15), 2456-2466. https://doi.org/10.1017/S0033291718000648

Vancouver

Karyotaki E, Kemmeren L, Riper H, Twisk J, Hoogendoorn A, Kleiboer A et al. Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. PSYCHOL MED. 2018 Nov;48(15):2456-2466. https://doi.org/10.1017/S0033291718000648

Bibtex

@article{e3e25d32510643c7b850ac4b8ca9cd76,
title = "Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis",
abstract = "BACKGROUND: Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration.METHODS: Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates.RESULTS: Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates.CONCLUSIONS: Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.",
keywords = "Journal Article, Telemedicine, Depressive Disorder/therapy, Humans, Depression/therapy, Cognitive Behavioral Therapy, Internet, Outcome Assessment, Health Care/statistics & numerical data",
author = "Eirini Karyotaki and Lise Kemmeren and Heleen Riper and Jos Twisk and Adriaan Hoogendoorn and Annet Kleiboer and Adriana Mira and Andrew Mackinnon and Bj{\"o}rn Meyer and Cristina Botella and Elizabeth Littlewood and Gerhard Andersson and Helen Christensen and Klein, {Jan P} and Johanna Schr{\"o}der and Juana Bret{\'o}n-L{\'o}pez and Justine Scheider and Kathy Griffiths and Louise Farrer and Huibers, {Marcus J H} and Rachel Phillips and Simon Gilbody and Steffen Moritz and Thomas Berger and Victor Pop and Viola Spek and Pim Cuijpers",
year = "2018",
month = nov,
doi = "10.1017/S0033291718000648",
language = "English",
volume = "48",
pages = "2456--2466",
journal = "PSYCHOL MED",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "15",

}

RIS

TY - JOUR

T1 - Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis

AU - Karyotaki, Eirini

AU - Kemmeren, Lise

AU - Riper, Heleen

AU - Twisk, Jos

AU - Hoogendoorn, Adriaan

AU - Kleiboer, Annet

AU - Mira, Adriana

AU - Mackinnon, Andrew

AU - Meyer, Björn

AU - Botella, Cristina

AU - Littlewood, Elizabeth

AU - Andersson, Gerhard

AU - Christensen, Helen

AU - Klein, Jan P

AU - Schröder, Johanna

AU - Bretón-López, Juana

AU - Scheider, Justine

AU - Griffiths, Kathy

AU - Farrer, Louise

AU - Huibers, Marcus J H

AU - Phillips, Rachel

AU - Gilbody, Simon

AU - Moritz, Steffen

AU - Berger, Thomas

AU - Pop, Victor

AU - Spek, Viola

AU - Cuijpers, Pim

PY - 2018/11

Y1 - 2018/11

N2 - BACKGROUND: Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration.METHODS: Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates.RESULTS: Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates.CONCLUSIONS: Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.

AB - BACKGROUND: Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration.METHODS: Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates.RESULTS: Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates.CONCLUSIONS: Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.

KW - Journal Article

KW - Telemedicine

KW - Depressive Disorder/therapy

KW - Humans

KW - Depression/therapy

KW - Cognitive Behavioral Therapy

KW - Internet

KW - Outcome Assessment, Health Care/statistics & numerical data

U2 - 10.1017/S0033291718000648

DO - 10.1017/S0033291718000648

M3 - SCORING: Review article

C2 - 29540243

VL - 48

SP - 2456

EP - 2466

JO - PSYCHOL MED

JF - PSYCHOL MED

SN - 0033-2917

IS - 15

ER -