Effectiveness of blended cognitive behavioral therapy versus treatment as usual for depression in routine specialized mental healthcare: E-COMPARED trial in the Netherlands
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Abstract Background The general aim of this study was to investigate the effectiveness of blended Cognitive Behavioral Therapy (bCBT) as compared to Treatment as Usual (TAU) for depression in specialized routine mental healthcare in the Netherlands. We further explored a range of secondary outcome variables, including quality of life, clinical response, remission and reliable improvement, as well as clinical deterioration and potential negative effects of treatment. Methods n = 103 patients with Major Depressive Disorder were recruited as part of the E-COMPARED project, and randomly allocated to bCBT (n = 53) or TAU (n = 50). Measurements took place at baseline, 3-, 6- and 12-months follow-up. Treatment effects were analyzed using linear mixed-effects models for repeated measures. Results Depressive symptoms significantly declined and quality of life significantly improved over time in both bCBT and TAU during 12-months follow-up. No significant interaction effects between treatment group and assessment point were found. Likewise, there were no significant differences between the two treatment groups on secondary outcomes. Patients following bCBT went from severe to mild symptom severity, along with large within-group effects. Conclusion Applying bCBT in routine specialized mental health care seems promising, but is a relatively new form of treatment that is still under development and more research is needed. Clinical Trial Registration Netherlands Trials Register NTR4962. Registered on 5 January 2015.
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Randomized controlled trials have shown efficacy of blended treatments for depression and anxiety, and a meta-analysis found blended interventions more effective or non-inferior to treatment-as-usual for depression.
“randomized controlled trials (RCTs) have shown the efficacy of blended treatments for depression (e.g., Kemmeren et al., 2023) and for anxiety (e.g., Romijn et al., 2021), and a recent meta-analysis has found blended interventions to be more effective or non-inferior to treatment-as-usual for depression (Nunes-Zlotkowski et al., 2024).”
From Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders (2025) · cites this paper as Kemmeren et al., 2023
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- Authors
- Kemmeren, L. L., van Schaik, A., Draisma, S., Kleiboer, A., Riper, H., & Smit, J. H.
- Affiliations
- Amsterdam Public Health (NL)
- Trimbos Institute (NL)
- Corresponding author
- Kemmeren, L. L.
- Venue
- Cognitive Therapy and Research
- Published
- 2023-03-24
- Volume
- 47
- Issue
- 3
- Pages
- 386-398
- ISSN
- 0147-5916 (ISSN-L)
- 1573-2819
- OpenAlex
- W4360825332
- Cited by
- 22
- References
- 53
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 6
- FWCI
- 5.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Cognitive Therapy and Research (publishedVersion, cc-by)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Seventh Framework Programme (603098-2)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- major depressive disorder, depression treatment, usual care, quality of life, remission, clinical deterioration, treatment effects
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