Do guided internet-based interventions result in clinically relevant changes for patients with depression?: An individual participant data meta-analysisVrije University Amsterdam, Netherlands.
Univ Amsterdam, Netherlands.
Univ Utrecht, Netherlands.
Friedrich Alexander Univ Erlangen Nurnberg, Germany.
HumanTotalCare, Netherlands.
Vrije university Amsterdam, Netherlands;Amsterdam Public Health Research Institute, Netherlands.
Vrije university Amsterdam, Netherlands;Amsterdam Public Health Research Institute, Netherlands.
Gaia AG, Germany;City Univ London, UK.
Middle East Tech Univ, Turkey.
Friedrich Alexander Univ Erlangen Nurnberg, Germany.
Leuphana Univ Luneburg, Germany.
Vrije University Amsterdam, Netherlands.
Univ New South Wales, Australia.
Vrije university Amsterdam, Netherlands;Amsterdam Public Health Research Institute, Netherlands.
Luebeck Univ, Germany.
Univ New South Wales, Australia;MRC Cognit & Brain Sci Unit, UK.
Univ Med Ctr Hamburg Eppendorf, Germany;Inst Sex Res & Forens Psychiat, Germany.
Friedrich Alexander Univ Erlangen Nurnberg, Germany.
Vrije University Amsterdam, Netherlands.
Univ Tokyo, Japan.
Linköping University, Sweden.
Leuphana Univ Luneburg, Germany.
Oregon Res Inst, USA.
University of Gothenburg, Sweden.
Friedrich Alexander Univ Erlangen Nurnberg, Germany.
Macquarie Univ, Australia.
Stockholm University, Sweden;Univ Southern Denmark, Denmark.
Linköping University, Sweden;Karolinska Institutet, Sweden.
Univ Bergen, Norway.
St Vincents Hosp, Australia.
Vrije university Amsterdam, Netherlands;Amsterdam Public Health Research Institute, Netherlands.
Leuphana Univ Luneburg, Germany.
Univ Bern, Switzerland.
Karolinska Institutet, Sweden.
Karolinska Institutet, Sweden.
Karolinska Institutet, Sweden.
University of Gothenburg, Sweden.
Univ Tokyo, Japan.
Vrije university Amsterdam, Netherlands;Amsterdam Public Health Research Institute, Netherlands.
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2018 (English)In: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 63, p. 80-92Article, review/survey (Refereed) Published
Abstract [en]
Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving intemet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.
Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 63, p. 80-92
Keywords [en]
Internet-based guided self-help, Psychotherapy, Depression, Meta-analysis
National Category
Psychology
Research subject
Health and Caring Sciences, Health Informatics; Social Sciences, Psychology
Identifiers
URN: urn:nbn:se:lnu:diva-77405DOI: 10.1016/j.cpr.2018.06.007ISI: 000439086800007PubMedID: 29940401Scopus ID: 2-s2.0-85048853348OAI: oai:DiVA.org:lnu-77405DiVA, id: diva2:1242778
2018-08-292018-08-292020-10-20Bibliographically approved