Predicting outcome of Internet-based treatment for depressive symptoms

Abstract In this study we explored predictors and moderators of response to Internet-based cognitive behavioral therapy (CBT) and Internet-based problem-solving therapy (PST) for depressive symptoms. The sample consisted of 263 participants with moderate to severe depressive symptoms. Of those, 88 were randomized to CBT, 88 to PST and 87 to a waiting list control condition. Outcomes were improvement and clinically significant change in depressive symptoms after 8 weeks. Higher baseline depression and higher education predicted improvement, while higher education, less avoidance behavior and decreased rational problem-solving skills predicted clinically significant change across all groups. No variables were found that differentially predicted outcome between Internet-based CBT and Internet-based PST. More research is needed with sufficient power to investigate predictors and moderators of response to reveal for whom Internet-based therapy is best suited.

[1]  G. Andersson,et al.  Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data , 2013, BMJ : British Medical Journal.

[2]  J. Ruwaard,et al.  Standardized Web-Based Cognitive Behavioural Therapy of Mild to Moderate Depression: A Randomized Controlled Trial with a Long-Term Follow-Up , 2009, Cognitive behaviour therapy.

[3]  Heleen Riper,et al.  Internet-Based Treatment for Adults with Depressive Symptoms: Randomized Controlled Trial , 2008, Journal of medical Internet research.

[4]  R. Schoevers,et al.  Predicting the Outcome of Antidepressants and Psychotherapy for Depression: A Qualitative, Systematic Review , 2008, Harvard review of psychiatry.

[5]  Pim Cuijpers,et al.  Effectiveness of a Web-Based Self-Help Intervention for Symptoms of Depression, Anxiety, and Stress: Randomized Controlled Trial , 2008, Journal of medical Internet research.

[6]  P. Cuijpers,et al.  Predictors of outcome of group and internet-based cognitive behavior therapy. , 2008, Journal of affective disorders.

[7]  P. Cuijpers,et al.  Internet-based treatment for adults with depressive symptoms: the protocol of a randomized controlled trial , 2007, BMC psychiatry.

[8]  Lisanne Warmerdam,et al.  Problem solving therapies for depression: A meta-analysis , 2007, European Psychiatry.

[9]  R. Bagby,et al.  Attachment as moderator of treatment outcome in major depression: a randomized control trial of interpersonal psychotherapy versus cognitive behavior therapy. , 2006, Journal of consulting and clinical psychology.

[10]  Heleen Riper,et al.  Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis , 2006, Psychological Medicine.

[11]  A. Beck,et al.  The empirical status of cognitive-behavioral therapy: a review of meta-analyses. , 2006, Clinical psychology review.

[12]  F. Raes,et al.  De Nederlandstalige versie van de Dysfunctional Attitude Scale-vorm A (DAS-A-NL) , 2005 .

[13]  G. Andersson,et al.  Delivering Cognitive Behavioural Therapy for Mild to Moderate Depression via the Internet: Predicting Outcome at 6-Month Follow-Up , 2004, Verhaltenstherapie.

[14]  R. Slotten,et al.  Coping with Depression , 1989, Journal of Cognitive Psychotherapy.

[15]  B. Everitt,et al.  Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice , 2003, Psychological Medicine.

[16]  H. Kraemer,et al.  Mediators and moderators of treatment effects in randomized clinical trials. , 2002, Archives of general psychiatry.

[17]  J. Schafer,et al.  Missing data: our view of the state of the art. , 2002, Psychological methods.

[18]  J. Ormel,et al.  A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects , 1997, Psychological Medicine.

[19]  Herman Aguinis,et al.  Methodological Artifacts in Moderated Multiple Regression and Their Effects on Statistical Power , 1997 .

[20]  J. Barber,et al.  The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: empirical findings from the treatment for depression collaborative research program. , 1996, Journal of consulting and clinical psychology.

[21]  R. Brooks EuroQol: the current state of play. , 1996, Health policy.

[22]  M. Thase,et al.  Toward an integration of psychologic, social, and biologic factors in depression: effects on outcome and course of cognitive therapy. , 1995, Journal of consulting and clinical psychology.

[23]  Daniel Bowman,et al.  The Efficacy of Self-Examination Therapy and Cognitive Bibliotherapy in the Treatment of Mild to Moderate Depression , 1995 .

[24]  M. Barkham,et al.  Effects of treatment duration and severity of depression on the effectiveness of cognitive-behavioral and psychodynamic-interpersonal psychotherapy. , 1994, Journal of consulting and clinical psychology.

[25]  P. Areán,et al.  Comparative effectiveness of social problem-solving therapy and reminiscence therapy as treatments for depression in older adults. , 1993, Journal of consulting and clinical psychology.

[26]  W M Grove,et al.  Cognitive therapy and pharmacotherapy for depression. Singly and in combination. , 1992, Archives of general psychiatry.

[27]  M. Shea,et al.  Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH Treatment of Depression Collaborative Research Program. , 1991, The American journal of psychiatry.

[28]  M. Thase,et al.  Severity of depression and response to cognitive behavior therapy. , 1991, The American journal of psychiatry.

[29]  A. Rush,et al.  Clinical, cognitive, and demographic predictors of response to cognitive therapy for depression: A preliminary report , 1991, Psychiatry Research.

[30]  N. Jacobson,et al.  Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. , 1991, Journal of consulting and clinical psychology.

[31]  S. Hollon,et al.  Cognitive therapy and pharmacotherapy for depression. , 1990, Journal of consulting and clinical psychology.

[32]  R. Daldrup,et al.  Predictors of differential response to cognitive, experiential, and self-directed psychotherapeutic procedures. , 1991, Journal of consulting and clinical psychology.

[33]  P. Lewinsohn,et al.  Group treatment of depression: individual predictors of outcome. , 1988, Journal of consulting and clinical psychology.

[34]  P. Lewinsohn,et al.  GROUP THERAPY FOR DEPRESSION: THE COPING WITH DEPRESSION COURSE , 1984 .

[35]  A. Weissman The Dysfunctional Attitude Scale: A Validation Study , 1979 .