The more I got, the less I need? Efficacy of internet-based guided self-help compared to online psychoeducation for major depressive disorder
Abstract
Background This study's aims were to compare the efficacy and negative effects of guided Internet-based cognitive behavior therapy (iCBT) and online psychoeducation (OPE) in people with major depression.Methods A total of 131 individuals were randomized. Assessments took place at baseline (T1), six weeks (T2), and three months (T3). The primary endpoint was change in observer-based depression severity from T1 to T2. Potential negative effects were analyzed in terms of suicidal ideations, symptom deterioration, attitudes toward seeking further help, and other adverse events.Results iCBT (n = 65) and OPE (n = 66) both reduced depressive symptoms from T1 to T2, with large changes observed for iCBT and medium for OPE (iCBT: Cohen's d = 1.09; OPE: d = 0.60). Differences between groups were significant at the primary endpoint (d = 0.36, p = 0.028). OPE continued to have a positive effect from post-treatment to follow-up, while the effect of iCBT remained stable, with differences between groups not being significant anymore at follow-up. Participants who had undergone prior psychotherapy benefited from both treatments; but for those without prior psychotherapy, iCBT was superior also at follow-up. In the iCBT group 26.2% of the participants reported at least one side-effect.Limitations The history of psychotherapy was imbalanced between the groups. Some negative effects were assessed in the iCBT group only.Conclusions Both iCBT and OPE were effective in reducing depressive symptoms, but with iCBT having a more rapid effect. iCBT was specifically superior in those with no prior history of psychotherapy. Negative effects occurred frequently and should be considered when implementing iCBT.Trial registration German clinical trials register: DRKS00005025.
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The intervention is based on GET.ON Mood Enhancer, a program that has been evaluated in multiple randomised controlled trials.
“The intervention is based on “GET.ON Mood Enhancer,” a program that has been evaluated in multiple randomised controlled trials (62–64).”
From Personalised depression forecasting using mobile sensor data and ecological momentary assessment (2022) · cites this paper as [64]
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- Authors
- Reins, J. A., Boß, L., Lehr, D., Berking, M., & Ebert, D. D.
- Affiliations
- Leuphana University of Lüneburg (DE)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Corresponding author
- Reins, Jo Annika
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 246
- Pages
- 695-705
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2905605668
- Cited by
- 61
- References
- 73
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 12 · 2023: 8 · 2022: 13 · 2021: 13 · 2020: 6 · 2019: 1
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Multilingual Matters (Channel View Publications) (publishedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Philipps-Universität Marburg
- 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 › Social Psychology › Mental Health Treatment and Access
- Keywords
- internet-based cognitive behavioral therapy, online psychoeducation, major depressive disorder, depression treatment efficacy, adverse effects, suicidal ideation, treatment side effects, symptom deterioration
- MeSH terms
- Adult, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Patient Education as Topic, Psychotherapy, Self Care, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Suicidal Ideation
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