Evaluations

• A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression

  Richards D, Timulak L, O’Brien E, et al. Behaviour Research and Therapy. 2015. 75: 20-31. doi: 10.1016/j.brat.2015.10.005

  Summary: Researchers recruited adults with mild-to-moderate depressive symptoms (n = 188) to participate in a randomized controlled trial to evaluate the efficacy of Space from Depression in reducing symptoms of depression, anxiety, and functional impairment. Recruitment occurred among individuals enrolled in a charity for depression and related mood disorders using advertisements on the website of the charity. Eligible participants did not have a mental health diagnosis and were not currently in treatment for depression. Researchers randomized participants into the Space from Depression internet-delivered cognitive behavioral therapy (iCBT) intervention (n = 96) or a waitlist control (n = 92). Participants accessed the internet-based Space from Depression intervention via personal computer. Each intervention participant also received weekly support from a trained volunteer who monitored participant progress and provided asynchronous post-session feedback and encouragement (10 to 15 minutes per participant per session). Participants completed assessments of depression (Beck Depression Inventory-II (BDI-II), anxiety (Generalized Anxiety Disorder-7 (GAD-7), and functional impairment (Work and Social Adjustment Scale (WSAS) at baseline, 8 weeks (post-intervention), and 3- and 6-month follow-ups. The Space from Depression iCBT intervention demonstrated short-term (8 weeks) and longer-term (3 and 6 months) efficacy in significantly reducing symptoms of depression, anxiety, and functional impairment, relative to the control. From baseline to post-intervention among Space from Depression participants, mean BDI-II scores decreased 25.02% (vs. 1.97% control), mean GAD-7 scores reduced by 50.93% (vs. 19.37% control), and mean WSAS scores decreased 20.75% (vs. 7.00% control). Significant treatment gains improved (BDI-II and WSAS scores) or were maintained (GAD-7 scores) at the 6-month follow-up.

  Take away: Among adults with mild-to-moderate depressive symptoms, the Space from Depression intervention demonstrated preliminary short- and long-term efficacy in significantly reducing symptoms of depression, anxiety, and functional impairment, compared with the control.

• A culturally adapted cognitive behavioral internet-delivered intervention for depressive symptoms: Randomized controlled trial

  Salamanca-Sanabria A, Richards D, Timulak L, et al. JMIR Mental Health. 2020. 7(1): e13392. doi: 10.2196/13392

  Summary: Researchers recruited Colombian university students (mean age 22) with mild-to-moderate depressive symptoms (n = 214) to participate in a randomized controlled trial to test the efficacy of the Yo puedo sentirme bien (I can feel better) iCBT intervention in improving symptoms of depression. Yo puedo sentirme bien (a cultural and linguistic adaptation of the Space from Depression intervention) presents equivalent content in the same 7-module structure. All undergraduate and graduate students at two Colombian universities received a recruitment email with a link to the study website. Eligible participants did not have a mental health diagnosis and were not currently in treatment for depression. Researchers randomized participants into a control (n = 107) and the Yo puedo sentirme bien intervention (n = 107), which participants accessed via personal computer. Each intervention participant also received weekly support from a clinical psychology graduate student who monitored participant progress and provided asynchronous post-session feedback and encouragement (10 to 15 minutes per participant per session). Participants completed assessments of depressive symptoms (Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms (Generalized Anxiety Disorder-7 (GAD-7) at baseline, 7 weeks (post-intervention), and a 3-month follow-up and reported intervention satisfaction at post-intervention. Yo puedo sentirme bien demonstrated short-term (7 weeks) and long-term (3 months) efficacy in significantly reducing symptoms of depression and anxiety relative to the control. From baseline to post-intervention among Yo puedo sentirme bien participants, mean PHQ-9 scores decreased 41.42% (vs. 5.28% control) and mean GAD-7 scores reduced by 31.91% (control scores not available). Significant treatment gains were maintained at the 3-month follow-up. Most participants found Yo puedo sentirme bien easy to use (82%) and helpful (68%).

  Take away: Despite a high study dropout rate (just 9% of intervention participants completed all 7 modules), Yo puedo sentirme bien showed short- and long-term efficacy in significantly reducing symptoms of depression and anxiety (relative to the control) among Colombian university students with mild-to-moderate depressive symptoms who completed the study.  Future research could identify factors associated with premature dropout in internet interventions.

• Related Articles

  A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety. Richards D, Enrique A, Eilert N, et al. NPJ Digital Medicine. 2020. 3(1): 85. doi: 10.1038/s41746-020-0293-8