TY - JOUR

T1 - Predictors and moderators of response to internet-delivered Interpersonal Psychotherapy and Cognitive Behavior Therapy for depression

AU - Donker, Tara

AU - Batterham, P. J.

AU - Warmerdam, L.

AU - Bennett, K.

AU - Bennett, A.

AU - Cuijpers, Pim

AU - Griffiths, K. M.

AU - Christensen, H.

PY - 2013/10

Y1 - 2013/10

N2 - Background: By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. Method: An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy FIFT; n=6201 and Cognitive Behavioral Therapy FCBT; n=6101) to an active control intervention (M00dGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics rage, gender, marital status, education levell, clinical characteristics Fdepression!anxiety symptoms, disability, quality of life, medication usel, skills Fmastery and dysfunctional attitudesi and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM). Resu Its: Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and!or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered 1Ff may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs. Limitations: Although the sample of participants was large, power to detect moderator effects was still lacking. Conclusions: Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups.

AB - Background: By identifying which predictors and moderators lead to beneficial outcomes, accurate selection of the best initial treatment will have significant benefits for depressed individuals. Method: An automated, fully self-guided randomized controlled internet-delivered noninferiority trial was conducted comparing two new interventions (Interpersonal Psychotherapy FIFT; n=6201 and Cognitive Behavioral Therapy FCBT; n=6101) to an active control intervention (M00dGYM; n=613) over a period of 4 weeks to spontaneous visitors of an internet-delivered therapy website (e-couch). A range of putative predictors and moderators (socio-demographic characteristics rage, gender, marital status, education levell, clinical characteristics Fdepression!anxiety symptoms, disability, quality of life, medication usel, skills Fmastery and dysfunctional attitudesi and treatment preference) were assessed using internet-delivered self-report measures at baseline and immediately following treatment and at six months follow-up. Analyses were conducted using Mixed Model Repeated Measures (MMRM). Resu Its: Female gender, lower mastery and lower dysfunctional attitudes predicted better outcome at post-test and!or follow-up regardless of intervention. No overall differential effects for condition on depression as a function of outcome were found. However, based on time-specific estimates, a significant interaction effect of age was found. For younger people, internet-delivered 1Ff may be the preferred treatment choice, whereas older participants derive more benefits from internet-delivered CBT programs. Limitations: Although the sample of participants was large, power to detect moderator effects was still lacking. Conclusions: Different e-mental health programs may be more beneficial for specific age groups. The findings raise important possibilities for increasing depression treatment effectiveness and improving clinical practice guidelines for depression treatment of different age groups.

KW - Health sciences

KW - Interpersonal Psychotherapy

KW - Cognitive Behavior therapy

KW - Depressive symptoms

KW - Internet

KW - Predictor

KW - Moderator

KW - Psychology

UR - http://www.scopus.com/inward/record.url?scp=84888638859&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2013.06.020

DO - 10.1016/j.jad.2013.06.020

M3 - Journal articles

C2 - 23953024

VL - 151

SP - 343

EP - 351

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 1

ER -