Depression
Promising Results from CCBT in Depression
By British Journal of Psychiatry
Nov 10, 2005 - 7:01:00 PM

Internet-delivered cognitive-behavioural therapy should be pursued further as a complement to treatment, or treatment alternative, for mild to moderate depression, a new study from Sweden has found.

It is known that major depression can be treated with cognitive-behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many people with depression use the internet for discussion of their symptoms and to share their experiences.

This study, published in the November issue of the British Journal of Psychiatry, set out to compare the effects of an internet-administered self-help programme, including participation in a monitored, web-based discussion group, with participation in a web-based discussion group only.

117 people with mild to moderate depression who met a number of inclusion criteria were included in this randomised controlled trial. The majority came from smaller cities, villages and places outside the larger cities (where university clinics are usually based).

36 participants in the treatment group and 49 in the control group completed post-treatment measures.

In total the rate of withdrawal from the programme was 27%. The main reason given was that the treatment was too demanding. Thus the rates of withdrawal differed between the treatment group (37%) and the control group (18%).

It was found that the active treatment, which included standard cognitive-behavioural approaches and behavioural changes, resulted in decreased depressive symptoms immediately after treatment and at the six-month follow-up. There were also benefits in terms of anxiety symptoms and quality of life.

There was no change in depressive symptoms among the participants in the web-based discussion group only.

Being engaged in self-help seemed to affect the tendency to participate in a discussion group, with less activity in the group who received the active treatment immediately.

The authors of the study comment that adjusting the text in the treatment programme and allowing a longer treatment period could possibly reduce rates of withdrawal.

They conclude that internet-based self-help facilitates the spread of cognitive behavioural therapy for depression to those who do not usually have access to this form of treatment.

The outcome with internet-based therapy resembles that in controlled studies of clinician-delivered therapy.

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