Demographic and clinical predictors of response to internet-enabled cognitive-behavioural therapy for depression and anxiety.
Open accessAbstract
BACKGROUND: Common mental health problems affect a quarter of the population. Online cognitive-behavioural therapy (CBT) is increasingly used, but the factors modulating response to this treatment modality remain unclear. AIMS: This study aims to explore the demographic and clinical predictors of response to one-to-one CBT delivered via the internet. METHOD: Real-world clinical outcomes data were collected from 2211 NHS England patients completing a course of CBT delivered by a trained clinician via the internet. Logistic regression analyses were performed using patient and service variables to identify significant predictors of response to treatment. RESULTS: Multiple patient variables were significantly associated with positive response to treatment including older age, absence of long-term physical comorbidities and lower symptom severity at start of treatment. Service variables associated with positive response to treatment included shorter waiting times for initial assessment and longer treatment durations in terms of the number of sessions. CONCLUSIONS: Knowledge of which patient and service variables are associated with good clinical outcomes can be used to develop personalised treatment programmes, as part of a quality improvement cycle aiming to drive up standards in mental healthcare. This study exemplifies translational research put into practice and deployed at scale in the National Health Service, demonstrating the value of technology-enabled treatment delivery not only in facilitating access to care, but in enabling accelerated data capture for clinical research purposes. DECLARATION OF INTEREST: A.C., S.B., V.T., K.I., S.F., A.R., A.H. and A.D.B. are employees or board members of the sponsor. S.R.C. consults for Cambridge Cognition and Shire. Keywords: Anxiety disorders; cognitive behavioural therapies; depressive disorders; individual psychotherapy.
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- Authors
- Catarino, A., Bateup, S., Tablan, V., Innes, K., Freer, S., Richards, A., Stott, R., Hollon, S. D., Chamberlain, S. R., Hayes, A., & Blackwell, A. D.
- Affiliations
- ieso Digital Health (UK) Ltd. (United Kingdom) (GB)
- King's College London (GB)
- Vanderbilt University (US)
- University of Cambridge (GB)
- Corresponding author
- Catarino, Ana
- ORCID
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2018-09
- Volume
- 4
- Issue
- 5
- Pages
- 411-418
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC6171334
- OpenAlex
- W2894921310
- Cited by
- 40
- References
- 29
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 2
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (110,049/Z/15/Z, /Z/15/Z, 110049)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- internet-based cognitive behavioral therapy, online therapy, predictors of treatment response, depression, anxiety disorders, individual psychotherapy, waiting time, treatment duration, symptom severity, somatic comorbidity, personalized treatment, NHS England
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