Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation

Lena Jelinek; Sönke Arlt; Steffen Moritz; Johanna Schröder; Stefan Westermann; Barbara Cludius

doi:10.2196/15312

Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation

Standard

Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation. / Jelinek, Lena; Arlt, Sönke; Moritz, Steffen; Schröder, Johanna; Westermann, Stefan; Cludius, Barbara.

In: J MED INTERNET RES, Vol. 22, No. 3, 26.03.2020, p. e15312.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Jelinek, L, Arlt, S, Moritz, S, Schröder, J, Westermann, S & Cludius, B 2020, 'Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation', J MED INTERNET RES, vol. 22, no. 3, pp. e15312. https://doi.org/10.2196/15312

APA

Jelinek, L., Arlt, S., Moritz, S., Schröder, J., Westermann, S., & Cludius, B. (2020). Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation. J MED INTERNET RES, 22(3), e15312. https://doi.org/10.2196/15312

Vancouver

Jelinek L, Arlt S, Moritz S, Schröder J, Westermann S, Cludius B. Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation. J MED INTERNET RES. 2020 Mar 26;22(3):e15312. https://doi.org/10.2196/15312

Bibtex

@article{dd57628874404d80b3e2340143169868,

title = "Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation",

abstract = "BACKGROUND: 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).OBJECTIVE: 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.METHODS: We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, >4) via the internet at baseline (t0) and 2 weeks (t1) and 4 weeks (t2) later. After the t0 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.RESULTS: While groups did not differ regarding the change in depression from t0 to t1 (ηp2=.007, P=.746) or t0 to t2 (ηp2=.008, P=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t0 to t2 in comparison to CAU (ηp2=.053, P=.04) and a larger increase in activity from t0 to t1 than the pooled control groups (ηp2=.060, P=.02). A change in depression from t0 to t2 was mediated by a change in activity from t0 to t1. At t1, 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.CONCLUSIONS: 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.TRIAL REGISTRATION: DKRS (#DRKS00011562).",

author = "Lena Jelinek and S{\"o}nke Arlt and Steffen Moritz and Johanna Schr{\"o}der and Stefan Westermann and Barbara Cludius",

year = "2020",

month = mar,

day = "26",

doi = "10.2196/15312",

language = "English",

volume = "22",

pages = "e15312",

journal = "J MED INTERNET RES",

issn = "1438-8871",

publisher = "Journal of medical Internet Research",

number = "3",

}

RIS

TY - JOUR

T1 - Brief Web-Based Intervention for Depression: Randomized Controlled Trial on Behavioral Activation

AU - Jelinek, Lena

AU - Arlt, Sönke

AU - Moritz, Steffen

AU - Schröder, Johanna

AU - Westermann, Stefan

AU - Cludius, Barbara

PY - 2020/3/26

Y1 - 2020/3/26

N2 - BACKGROUND: 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).OBJECTIVE: 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.METHODS: We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, >4) via the internet at baseline (t0) and 2 weeks (t1) and 4 weeks (t2) later. After the t0 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.RESULTS: While groups did not differ regarding the change in depression from t0 to t1 (ηp2=.007, P=.746) or t0 to t2 (ηp2=.008, P=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t0 to t2 in comparison to CAU (ηp2=.053, P=.04) and a larger increase in activity from t0 to t1 than the pooled control groups (ηp2=.060, P=.02). A change in depression from t0 to t2 was mediated by a change in activity from t0 to t1. At t1, 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.CONCLUSIONS: 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.TRIAL REGISTRATION: DKRS (#DRKS00011562).

AB - BACKGROUND: 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).OBJECTIVE: 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.METHODS: We assessed 104 people with at least mild depressive symptoms (Patient Health Questionnaire-9, >4) via the internet at baseline (t0) and 2 weeks (t1) and 4 weeks (t2) later. After the t0 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.RESULTS: While groups did not differ regarding the change in depression from t0 to t1 (ηp2=.007, P=.746) or t0 to t2 (ηp2=.008, P=.735), iBA was associated with a larger decrease in dysfunctional attitudes from t0 to t2 in comparison to CAU (ηp2=.053, P=.04) and a larger increase in activity from t0 to t1 than the pooled control groups (ηp2=.060, P=.02). A change in depression from t0 to t2 was mediated by a change in activity from t0 to t1. At t1, 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.CONCLUSIONS: 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.TRIAL REGISTRATION: DKRS (#DRKS00011562).

U2 - 10.2196/15312

DO - 10.2196/15312

M3 - SCORING: Journal article

C2 - 32213470

VL - 22

SP - e15312

JO - J MED INTERNET RES

JF - J MED INTERNET RES

SN - 1438-8871

IS - 3

ER -