Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials

Publikation: Beiträge in ZeitschriftenZeitschriftenaufsätzeForschungbegutachtet


  • Jo Annika Reins
  • Claudia Buntrock
  • Johannes Zimmermann
  • Simon Grund
  • Mathias Harrer
  • Dirk Lehr
  • Harald Baumeister
  • Kiona Weisel
  • Matthias Domhardt
  • Kotaro Imamura
  • Norito Kawakami
  • Viola Spek
  • Stephanie Nobis
  • Frank Snoek
  • Pim Cuijpers
  • Jan Philipp Klein
  • Steffen Moritz
  • David Daniel Ebert

Introduction: Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. Objective: We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes. Methods: Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators. Results: Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment: 6-12 weeks; Hedges' g = 0.39 [95% CI: 0.25-0.53]; follow-up 1: 3-6 months; g = 0.30 [95% CI: 0.15-0.45]; follow-up 2: 12 months, g = 0.27 [95% CI: 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS. Conclusions: Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden.

ZeitschriftPsychotherapy and Psychosomatics
Seiten (von - bis)94-106
Anzahl der Seiten13
PublikationsstatusErschienen - 02.2021