The prevention of depression using the Internet

Efficacy trials suggest that depression is preventable in children and adults. However, current depression prevention interventions are not deliverable to the community en masse. The Internet offers an opportunity to deliver tailored prevention interventions such as those based on cognitive behavioural therapy (CBT) to a large audience, cost‐effectively, while preserving intervention fidelity and anonymity. The Internet offers distinct advantages for data collection, which can be used to help refine intervention programs. There are no published randomised controlled trials of the effectiveness of the Internet in delivering depression prevention programs. The feasibility and potential effectiveness of the Internet is indicated by research demonstrating the successful delivery of CBT by computer, the use of the Internet in the delivery of CBT treatment, and the effective prevention of obesity and the promotion of exercise using Internet technologies. Possible limitations to public health interventions using the Internet include selective access, the inability to promote the sites to potential users and the issue of uptake once users access the sites. Randomised controlled trials of CBT delivered by the Internet are required.

[1]  T N Robinson,et al.  An evidence-based approach to interactive health communication: a challenge to medicine in the information age. Science Panel on Interactive Communication and Health. , 1998, JAMA.

[2]  P. Manzo,et al.  Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open U.S.-U.K. study. , 1998, The Journal of clinical psychiatry.

[3]  S I Woodruff,et al.  Pilot test of an Internet virtual world chat room for rural teen smokers. , 2001, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[4]  John Powell,et al.  The WWW of the World Wide Web: Who, What, and Why? , 2002, Journal of medical Internet research.

[5]  J Pearson,et al.  Randomised trial of personalised computer based information for cancer patients , 1999, BMJ.

[6]  K. Echt,et al.  Development of an exercise expert system for older adults. , 1999, Journal of rehabilitation research and development.

[7]  E. Leslie,et al.  Interactive health communication in preventive medicine: internet-based strategies in teaching and research. , 2000, American journal of preventive medicine.

[8]  F. Martin,et al.  Computer-aided vicarious exposure versus live graded exposure for spider phobia in children. , 2001, Journal of behavior therapy and experimental psychiatry.

[9]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[10]  D Johnston,et al.  Implications of the results of community intervention trials. , 1998, Annual Review of Public Health.

[11]  R. Winett,et al.  Using Internet technology to deliver a behavioral weight loss program. , 2001, JAMA.

[12]  G. Andrews,et al.  Preventing major depression in young people , 2002, British Journal of Psychiatry.

[13]  C. Rosen Is the sequencing of change processes by stage consistent across health problems? A meta-analysis. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[14]  R. Wootton,et al.  Recent advances: Telemedicine. , 2001, BMJ.

[15]  A. Christensen,et al.  A comparison of computer-based versus traditional individual psychotherapy. , 2001 .

[16]  On-Line with the Friends of Bill W: Social Support and the Net , 2000 .

[17]  G. Andrews,et al.  The prevention of mental disorders in young people , 2002, The Medical journal of Australia.

[18]  M. Frommer,et al.  Criteria for evaluating evidence on public health interventions , 2002, Journal of epidemiology and community health.

[19]  J F Sallis,et al.  PACE+: interactive communication technology for behavior change in clinical settings. , 2000, American journal of preventive medicine.

[20]  T. Sheldon,et al.  Mental health promotion in high risk groups. , 1997, Quality in health care : QHC.

[21]  M. Fotheringham,et al.  Computer use and physical inactivity in young adults: Public health perils and potentials of new information technologies , 2000, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[22]  M. White,et al.  Online support for caregivers. Analysis of an Internet Alzheimer mailgroup. , 2000, Computers in nursing.

[23]  Gunther Eysenbach,et al.  Consumer health informatics , 2000, BMJ : British Medical Journal.

[24]  S. Budman,et al.  Behavioral health care dot-com and beyond: computer-mediated communications in mental health and substance abuse treatment. , 2000, The American psychologist.

[25]  Kathleen M Griffiths,et al.  Cognitive behaviour therapy (CBT): Analysis of site usage and changes in depression and anxiety scores , 2002 .

[26]  Alec Holt,et al.  Electronic Medical Consultation: A New Zealand Perspective , 2001, Journal of medical Internet research.

[27]  R. Prinz,et al.  Promoting intervention fidelity. Conceptual issues, methods, and preliminary results from the EARLY ALLIANCE prevention trial. , 2001, American journal of preventive medicine.

[28]  J. Bernhardt,et al.  Health education and the digital divide: building bridges and filling chasms. , 2000, Health education research.

[29]  I. Marks,et al.  Reducing demands on clinicians by offering computer-aided self-help for phobia/panic , 2001, British Journal of Psychiatry.

[30]  Yves Coppieters,et al.  Information Technologies, Health, and Globalization: Anyone Excluded? , 2001, Journal of medical Internet research.