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Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial
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Zeitschriftentitel: | Psychotherapy and Psychosomatics |
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Personen und Körperschaften: | , , , , , , , , , , , , , , , , , , |
In: | Psychotherapy and Psychosomatics, 85, 2016, 4, S. 218-228 |
Medientyp: | E-Article |
Sprache: | Englisch |
veröffentlicht: |
S. Karger AG
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Schlagwörter: |
author_facet |
Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz |
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author |
Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz |
spellingShingle |
Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz Psychotherapy and Psychosomatics Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial Psychiatry and Mental health Applied Psychology Clinical Psychology General Medicine |
author_sort |
klein, jan philipp |
spelling |
Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz 0033-3190 1423-0348 S. Karger AG Psychiatry and Mental health Applied Psychology Clinical Psychology General Medicine http://dx.doi.org/10.1159/000445355 <jats:p><b><i>Background:</i></b> Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. <b><i>Methods:</i></b> This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical settings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. <b><i>Results:</i></b> A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed signi&#xFB01;cantly between groups (t<sub>825</sub> = 6.12, p < 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was <i>d</i> = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with <i>d</i> = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). <b><i>Conclusions:</i></b> The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications.</jats:p> Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial Psychotherapy and Psychosomatics |
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title |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_unstemmed |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_full |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_fullStr |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_full_unstemmed |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_short |
Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_sort |
effects of a psychological internet intervention in the treatment of mild to moderate depressive symptoms: results of the evident study, a randomized controlled trial |
topic |
Psychiatry and Mental health Applied Psychology Clinical Psychology General Medicine |
url |
http://dx.doi.org/10.1159/000445355 |
publishDate |
2016 |
physical |
218-228 |
description |
<jats:p><b><i>Background:</i></b> Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. <b><i>Methods:</i></b> This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical settings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. <b><i>Results:</i></b> A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed signi&#xFB01;cantly between groups (t<sub>825</sub> = 6.12, p < 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was <i>d</i> = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with <i>d</i> = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). <b><i>Conclusions:</i></b> The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications.</jats:p> |
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author | Klein, Jan Philipp, Berger, Thomas, Schröder, Johanna, Späth, Christina, Meyer, Björn, Caspar, Franz, Lutz, Wolfgang, Arndt, Alice, Greiner, Wolfgang, Gräfe, Viola, Hautzinger, Martin, Fuhr, Kristina, Rose, Matthias, Nolte, Sandra, Löwe, Bernd, Andersson, Gerhard, Vettorazzi, Eik, Moritz, Steffen, Hohagen, Fritz |
author_facet | Klein, Jan Philipp, Berger, Thomas, Schröder, Johanna, Späth, Christina, Meyer, Björn, Caspar, Franz, Lutz, Wolfgang, Arndt, Alice, Greiner, Wolfgang, Gräfe, Viola, Hautzinger, Martin, Fuhr, Kristina, Rose, Matthias, Nolte, Sandra, Löwe, Bernd, Andersson, Gerhard, Vettorazzi, Eik, Moritz, Steffen, Hohagen, Fritz, Klein, Jan Philipp, Berger, Thomas, Schröder, Johanna, Späth, Christina, Meyer, Björn, Caspar, Franz, Lutz, Wolfgang, Arndt, Alice, Greiner, Wolfgang, Gräfe, Viola, Hautzinger, Martin, Fuhr, Kristina, Rose, Matthias, Nolte, Sandra, Löwe, Bernd, Andersson, Gerhard, Vettorazzi, Eik, Moritz, Steffen, Hohagen, Fritz |
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description | <jats:p><b><i>Background:</i></b> Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. <b><i>Methods:</i></b> This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical settings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. <b><i>Results:</i></b> A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed signi&#xFB01;cantly between groups (t<sub>825</sub> = 6.12, p < 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was <i>d</i> = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with <i>d</i> = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). <b><i>Conclusions:</i></b> The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications.</jats:p> |
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spelling | Klein, Jan Philipp Berger, Thomas Schröder, Johanna Späth, Christina Meyer, Björn Caspar, Franz Lutz, Wolfgang Arndt, Alice Greiner, Wolfgang Gräfe, Viola Hautzinger, Martin Fuhr, Kristina Rose, Matthias Nolte, Sandra Löwe, Bernd Andersson, Gerhard Vettorazzi, Eik Moritz, Steffen Hohagen, Fritz 0033-3190 1423-0348 S. Karger AG Psychiatry and Mental health Applied Psychology Clinical Psychology General Medicine http://dx.doi.org/10.1159/000445355 <jats:p><b><i>Background:</i></b> Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. <b><i>Methods:</i></b> This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical settings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. <b><i>Results:</i></b> A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed signi&#xFB01;cantly between groups (t<sub>825</sub> = 6.12, p < 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was <i>d</i> = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with <i>d</i> = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). <b><i>Conclusions:</i></b> The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications.</jats:p> Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial Psychotherapy and Psychosomatics |
spellingShingle | Klein, Jan Philipp, Berger, Thomas, Schröder, Johanna, Späth, Christina, Meyer, Björn, Caspar, Franz, Lutz, Wolfgang, Arndt, Alice, Greiner, Wolfgang, Gräfe, Viola, Hautzinger, Martin, Fuhr, Kristina, Rose, Matthias, Nolte, Sandra, Löwe, Bernd, Andersson, Gerhard, Vettorazzi, Eik, Moritz, Steffen, Hohagen, Fritz, Psychotherapy and Psychosomatics, Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial, Psychiatry and Mental health, Applied Psychology, Clinical Psychology, General Medicine |
title | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_full | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_fullStr | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_full_unstemmed | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_short | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
title_sort | effects of a psychological internet intervention in the treatment of mild to moderate depressive symptoms: results of the evident study, a randomized controlled trial |
title_unstemmed | Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial |
topic | Psychiatry and Mental health, Applied Psychology, Clinical Psychology, General Medicine |
url | http://dx.doi.org/10.1159/000445355 |