Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis
Publikation: Beiträge in Zeitschriften › Übersichtsarbeiten › Forschung
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in: Clinical Psychology Review, Jahrgang 63, 01.07.2018, S. 80-92.
Publikation: Beiträge in Zeitschriften › Übersichtsarbeiten › Forschung
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TY - JOUR
T1 - Do guided internet-based interventions result in clinically relevant changes for patients with depression?
T2 - An individual participant data meta-analysis
AU - Karyotaki, Eirini
AU - Ebert, David Daniel
AU - Donkin, Liesje
AU - Riper, Heleen
AU - Twisk, Jos
AU - Burger, Simone
AU - Rozental, Alexander
AU - Lange, Alfred
AU - Williams, Alishia D.
AU - Zarski, Anna Carlotta
AU - Geraedts, Anna
AU - van Straten, Annemieke
AU - Kleiboer, Annet
AU - Meyer, Björn
AU - Ünlü Ince, Burçin B.
AU - Buntrock, Claudia
AU - Lehr, Dirk
AU - Snoek, Frank J.
AU - Andrews, Gavin
AU - Andersson, Gerhard
AU - Choi, Isabella
AU - Ruwaard, Jeroen
AU - Klein, Jan Philipp
AU - Newby, Jill M.
AU - Schröder, Johanna
AU - Laferton, Johannes A.C.
AU - Van Bastelaar, Kim
AU - Imamura, Kotaro
AU - Vernmark, Kristofer
AU - Boß, Leif
AU - Sheeber, Lisa B.
AU - Kivi, Marie
AU - Berking, Matthias
AU - Titov, Nickolai
AU - Carlbring, Per
AU - Johansson, Robert
AU - Kenter, Robin
AU - Perini, Sarah
AU - Moritz, Steffen
AU - Nobis, Stephanie
AU - Berger, Thomas
AU - Kaldo, Viktor
AU - Forsell, Yvonne
AU - Lindefors, Nils
AU - Kraepelien, Martin
AU - Björkelund, Cecilia
AU - Kawakami, Norito
AU - Cuijpers, Pim
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients’ groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17–2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07–2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving internet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.
AB - Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients’ groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17–2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07–2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving internet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.
KW - Psychology
KW - Depression
KW - Internet-based guided self-help
KW - Meta-analysis
KW - Psychotherapy
UR - http://www.scopus.com/inward/record.url?scp=85048853348&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/6b1cf937-8118-3622-b597-524d6bcd9e08/
U2 - 10.1016/j.cpr.2018.06.007
DO - 10.1016/j.cpr.2018.06.007
M3 - Scientific review articles
C2 - 29940401
AN - SCOPUS:85048853348
VL - 63
SP - 80
EP - 92
JO - Clinical Psychology Review
JF - Clinical Psychology Review
SN - 0272-7358
ER -