Cited by 154Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

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The Clinical Effectiveness of Web-Based Cognitive Behavioral Therapy With Face-to-Face Therapist Support for Depressed Primary Care Patients: Randomized Controlled Trial

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Høifødt, Ragnhild Sørensen, Lillevoll, Kjersti R, Griffiths, Kathleen M, Wilsgaard, Tom, Eisemann, Martin, Waterloo, Knut, Kolstrup, Nils·2013·Journal of Medical Internet Research

DOI 10.2196/jmir.2714PMC PMC3742404

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Abstract

BACKGROUND: Most patients with mild to moderate depression receive treatment in primary care, but despite guideline recommendations, structured psychological interventions are infrequently delivered. Research supports the effectiveness of Internet-based treatment for depression; however, few trials have studied the effect of the MoodGYM program plus therapist support. The use of such interventions could improve the delivery of treatment in primary care. OBJECTIVE: To evaluate the effectiveness and acceptability of a guided Web-based intervention for mild to moderate depression, which could be suitable for implementation in general practice. METHODS: Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition comprising 6 weeks of therapist-assisted Web-based cognitive behavioral therapy (CBT), or to a 6-week delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, brief face-to-face support from a psychologist, and reminder emails. The primary outcome measure, depression symptoms, was measured by the Beck Depression Inventory-II (BDI-II). Secondary outcome measures included the Beck Anxiety Inventory (BAI), the Hospital Anxiety and Depression Scale (HADS), the Satisfaction with Life Scale (SWLS), and the EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D). All outcomes were based on self-report and were assessed at baseline, postintervention, and at 6-month follow-up. RESULTS: Postintervention measures were completed by 37 (71%) and 47 (87%) of the 52 participants in the intervention and 54 participants in the delayed treatment group, respectively. Linear mixed-models analyses revealed a significant difference in time trends between the groups for the BDI-II, (P=.002), for HADS depression and anxiety subscales (P<.001 and P=.001, respectively), and for the SWLS (P<.001). No differential group effects were found for the BAI and the EQ-5D. In comparison to the control group, significantly more participants in the intervention group experienced recovery from depression as measured by the BDI-II. Of the 52 participants in the treatment program, 31 (60%) adhered to the program, and overall treatment satisfaction was high. The reduction of depression and anxiety symptoms was largely maintained at 6-month follow-up, and positive gains in life satisfaction were partly maintained. CONCLUSIONS: The intervention combining MoodGYM and brief therapist support can be an effective treatment of depression in a sample of primary care patients. The intervention alleviates depressive symptoms and has a significant positive effect on anxiety symptoms and satisfaction with life. Moderate rates of nonadherence and predominately positive evaluations of the treatment also indicate the acceptability of the intervention. The intervention could potentially be used in a stepped-care approach, but remains to be tested in regular primary health care. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12610000257066; http://apps.who.int/trialsearch/trial.aspx?trialid=ACTRN12610000257066 (Archived by WebCite at http://www.webcitation.org/6Ie3YhIZa).

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Figure 1 Screenshots from MoodGYM.CC BY · PubMed Central

Figure 2 Flow of participants through the trial.CC BY · PubMed Central

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Result
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“이러한 심리적 증상은 비용효과, 효과적인 전달 체계 및 접근성이 높은 근거중심치료의 요구도가 크다[8].”

Authors: Høifødt, R. S., Lillevoll, K. R., Griffiths, K. M., Wilsgaard, T., Eisemann, M., Waterloo, K., & Kolstrup, N.
Affiliations: UiT The Arctic University of Norway (NO)
Australian National University (AU)
Corresponding author: Høifødt, Ragnhild Sørensen
ORCID: Høifødt, Ragnhild Sørensen
Lillevoll, Kjersti R
Griffiths, Kathleen M
Wilsgaard, Tom
Eisemann, Martin
Waterloo, Knut
Kolstrup, Nils
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2013-08-05
Volume: 15
Issue: 8
Pages: e153
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.2714
PMC: PMC3742404
OpenAlex: W2075700213
Cited by: 154
References: 114
Citations by year: 2026: 3 · 2025: 8 · 2024: 13 · 2023: 7 · 2022: 11 · 2021: 9 · 2020: 10 · 2019: 12 · 2018: 13 · 2017: 21 · 2016: 21 · 2015: 15 · 2014: 10 · 2013: 1
FWCI: 24.14
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Journal of Medical Internet Research (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
ANU Open Research (Australian National University) (submittedVersion)
Funders: Universitetet i Tromsø
Australian National University
Norges Forskningsråd
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 › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: depression, internet-based cognitive behavioral therapy, MoodGYM, primary care, mild to moderate depression, medication adherence, treatment satisfaction, anxiety symptoms, life satisfaction, treatment delay, acceptability, cost-effectiveness, quality of life
MeSH terms: Adult, Depression, Female, Humans, Male, Middle Aged, Patient Compliance, Primary Health Care, Cognitive Behavioral Therapy, Internet

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The Clinical Effectiveness of Web-Based Cognitive Behavioral Therapy With Face-to-Face Therapist Support for Depressed Primary Care Patients: Randomized Controlled Trial

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