Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial.
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Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial. / Meyer, Björn; Berger, Thomas; Caspar, Franz; Beevers, Christopher G; Andersson, Gerhard; Weiss, Mario.
In: J MED INTERNET RES, Vol. 11, No. 2, 2, 2009, p. 15.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial.
AU - Meyer, Björn
AU - Berger, Thomas
AU - Caspar, Franz
AU - Beevers, Christopher G
AU - Andersson, Gerhard
AU - Weiss, Mario
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. OBJECTIVE: To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. METHODS: There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Complete analyses and intention-to-treat analyses were performed. RESULTS: Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen's d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen's d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen's d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen's d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR = 17.3, 95% CI 2.3 - 130). More than 80% of the users felt subjectively that the program had been helpful. CONCLUSIONS: This integrative, Web-based intervention was effective in reducing symptoms of depression and in improving social functioning. Findings suggest that the program could serve as an adjunctive or stand-alone treatment tool for patients suffering from symptoms of depression.
AB - BACKGROUND: Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. OBJECTIVE: To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. METHODS: There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Complete analyses and intention-to-treat analyses were performed. RESULTS: Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen's d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen's d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen's d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen's d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR = 17.3, 95% CI 2.3 - 130). More than 80% of the users felt subjectively that the program had been helpful. CONCLUSIONS: This integrative, Web-based intervention was effective in reducing symptoms of depression and in improving social functioning. Findings suggest that the program could serve as an adjunctive or stand-alone treatment tool for patients suffering from symptoms of depression.
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Psychiatric Status Rating Scales
KW - Behavior
KW - Behavior Therapy
KW - Cognition
KW - Depression psychology
KW - Depressive Disorder therapy
KW - Emotions
KW - Exercise
KW - Follow-Up Studies
KW - Internet
KW - Life Style
KW - Online Systems
KW - Patient Education as Topic
KW - Personality Inventory
KW - Problem Solving
KW - Social Adjustment
KW - Social Behavior
KW - Social Support
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Psychiatric Status Rating Scales
KW - Behavior
KW - Behavior Therapy
KW - Cognition
KW - Depression psychology
KW - Depressive Disorder therapy
KW - Emotions
KW - Exercise
KW - Follow-Up Studies
KW - Internet
KW - Life Style
KW - Online Systems
KW - Patient Education as Topic
KW - Personality Inventory
KW - Problem Solving
KW - Social Adjustment
KW - Social Behavior
KW - Social Support
U2 - 10.2196/jmir.1151
DO - 10.2196/jmir.1151
M3 - SCORING: Zeitschriftenaufsatz
VL - 11
SP - 15
JO - J MED INTERNET RES
JF - J MED INTERNET RES
SN - 1438-8871
IS - 2
M1 - 2
ER -
