Long-term effects of internet-delivered cognitive behavioral therapy for depression in primary care - the PRIM-NET controlled trial
Open accessAbstract
OBJECTIVE: Internet-delivered cognitive behavioral therapy (ICBT) is recommended as an efficient treatment alternative for depression in primary care. However, only few previous studies have been conducted at primary care centers (PCCs). We evaluated long-term effects of ICBT treatment for depression compared to treatment as usual (TAU) in primary care settings. DESIGN: Randomized controlled trial. SETTING: Patients were enrolled at16 PCCs in south-west Sweden. PARTICIPANTS: Patients attending PCCs and diagnosed with depression (n = 90). INTERVENTIONS: Patients were assessed by a primary care psychologist/psychotherapist and randomized to ICBT or TAU. The ICBT included an ICBT program consisting of seven modules and weekly therapist e-mail or telephone support during the 3-month treatment period. MAIN OUTCOME MEASURES: Questionnaires on depressive symptoms (BDI-II), quality of life (EQ-5D) and psychological distress (GHQ-12) were administered at baseline, with follow-ups at 3, 6 and 12 months. Antidepressants and sedatives use, sick leave and PCC contacts were registered. RESULTS: Intra-individual change in depressive symptoms did not differ between the ICBT group and the TAU group during the treatment period or across the follow-up periods. At 3-month follow-up, significantly fewer patients in ICBT were on antidepressants. However, the difference leveled out at later follow-ups. There were no differences between the groups concerning psychological distress, sick leave or quality of life, except for a larger improvement in quality of life in the TAU group during the 0- to 6-month period. CONCLUSIONS: ICBT with weekly minimal therapist support in primary care can be equally effective as TAU among depressed patients also over a 12-month period. CLINICAL TRIAL REGISTRATION: The trial was registered in the Swedish Registry, researchweb.org, ID number 30511.
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- Authors
- Eriksson, M. C. M., Kivi, M., Hange, D., Petersson, E.-L., Ariai, N., Häggblad, P., Ågren, H., Spak, F., Lindblad, U., Johansson, B., & Björkelund, C.
- Affiliations
- University of Gothenburg (SE)
- Region Västra Götaland (SE)
- Corresponding author
- Eriksson, Maria C. M.
- ORCID
- Venue
- Scandinavian Journal of Primary Health Care
- Publisher
- Informa UK Limited
- Published
- 2017-04-03
- Volume
- 35
- Issue
- 2
- Pages
- 126-136
- ISSN
- 0281-3432 (ISSN-L)
- 1502-7724
- PMC
- PMC5499312
- OpenAlex
- W2621865512
- Cited by
- 43
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 8 · 2017: 2
- FWCI
- 6.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Scandinavian Journal of Primary Health Care (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- REHSAM
- Region Västra Götaland
- 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, depression, primary care, long-term treatment outcomes, usual care, antidepressant use, quality of life, psychological distress, sick leave
- MeSH terms
- Adult, Aged, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Primary Health Care, Quality of Life, Sweden, Cognitive Behavioral Therapy, Internet
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