A Comparison of Changes in Anxiety and Depression Symptoms of Spontaneous Users and Trial Participants of a Cognitive Behavior Therapy Website

Background In randomized controlled trials Internet sites have been shown to be effective in the treatment of depression and anxiety. However, it is unclear if the positive effects demonstrated in these trials transfer to community users of such sites. Objective To compare anxiety and depression outcomes for spontaneous visitors to a publicly accessible cognitive behavior therapy website (MoodGYM) (http://moodgym.anu.edu.au) with outcomes achieved through a randomized controlled efficacy trial of the same site. Methods All community visitors to the MoodGYM site between April 2001 and September 2003 were sampled: 182 participants in the BlueMood Trial who had been randomly assigned to the MoodGYM site as part of a large trial and 19607 visitors (public registrants) to the site. Symptom assessments (quizzes) were repeated within the website intervention to allow the examination of change in symptoms across modules. Outcome variables were (1) age, gender, initial depression severity scores, and number of assessments attempted, and (2) symptom change measures based on Goldberg anxiety and depression scores recorded on a least two occasions. Results Public registrants did not differ from trial participants in gender, age, or initial level of depression, which was high for both groups relative to previously published epidemiological data sets. Trial participants completed more assessments. No significant differences in anxiety or depression change scores were observed, with both public registrants and trial participants improving through the training program. Conclusions Public registrants to a cognitive behavior therapy website show significant change in anxiety and depression symptoms. The extent of change does not differ from that exhibited by participants enrolled on the website for a randomized controlled trial.

[1]  G. Andrews,et al.  Interpreting scores on the Kessler Psychological Distress Scale (K10) , 2001, Australian and New Zealand journal of public health.

[2]  Kathleen M Griffiths,et al.  Web-based Cognitive Behavior Therapy: Analysis of Site Usage and Changes in Depression and Anxiety Scores , 2002, Journal of medical Internet research.

[3]  J. Kenardy,et al.  Internet-Delivered Indicated Prevention For Anxiety Disorders: A Randomized Controlled Trial , 2003, Behavioural and Cognitive Psychotherapy.

[4]  M. Alvarenga,et al.  Extension and Replication of an Internet-Based Treatment Program for Panic Disorder , 2002 .

[5]  G. Andrews,et al.  A Scale to Measure the Stress of Life Events* , 1976, The Australian and New Zealand journal of psychiatry.

[6]  P. Lewinsohn,et al.  The Pleasant Events Schedule: Studies on Reliability, Validity, and Scale Intercorrelation. , 1982 .

[7]  E. Coiera.  Four rules for the reinvention of health care , 2004, BMJ : British Medical Journal.

[8]  P. Duncan-Jones,et al.  Detecting anxiety and depression in general medical settings. , 1988, BMJ.

[9]  W. A. Wade,et al.  Effectiveness of cognitive therapy for depression in a community mental health center: a benchmarking study. , 2003, Journal of consulting and clinical psychology.

[10]  P. Mitchell,et al.  The development of a refined measure of dysfunctional parenting and assessment of its relevance in patients with affective disorders , 1997, Psychological Medicine.

[11]  Scott B Patten,et al.  Prevention of depressive symptoms through the use of distance technologies. , 2003, Psychiatric services.

[12]  B. Klein,et al.  A BRIEF INTERNET-BASED TREATMENT FOR PANIC DISORDER , 2001 .

[13]  J. Weisz,et al.  Community clinic treatment of depressed youth: benchmarking usual care against CBT clinical trials. , 2002, Journal of consulting and clinical psychology.

[14]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[15]  F. Lynch,et al.  Overcoming Depression on the Internet (ODIN): A Randomized Controlled Trial of an Internet Depression Skills Intervention Program , 2002, Journal of medical Internet research.