Internet CBT for depression reviewed and analyzed

Date:
August 2, 2021
Source:
University of Gothenburg
Summary:
Internet-based cognitive behavioral therapy (CBT) for depression is
often just as effective as traditional CBT. This is clear from an
international study. However, some online treatments have components
that can potentially be harmful.



FULL STORY ========================================================================== Internet-based cognitive behavioral therapy (CBT) for depression is often
just as effective as traditional CBT. This is clear from an international
study involving scientists at the University of Gothenburg. However,
some online treatments have components that can be harmful.


========================================================================== Internet CBT (iCBT) as a method of delivering treatment is on the
increase.

Nevertheless, it has been unclear to date which parts of the treatment
are most helpful against depression, which are less efficacious and
which are potentially detrimental to patients.

In an international study, researchers at the University of Gothenburg participated in a systematic literature review and meta-analysis. The
study was based on 76 randomized controlled trials (RCTs) in Sweden
and elsewhere. In total, the RCTs included 17,521 patients, 71% of whom
were women.

The study, under the aegis of Kyoto University in Japan, is now published
in The Lancet Psychiatry. One coauthor is Cecilia Bjo"rkelund, Senior
Professor of Family Medicine at the University of Gothenburg's Sahlgrenska Academy.

"In mild or moderate depression, the effect of iCBT is as good as that of conventional CBT. For many, it's a superb way of getting access to therapy without having to go to a therapist. We also saw that it was especially
good for the elderly -- a finding we didn't entirely expect," she says.

Just as in traditional CBT, its online counterpart involves modifying
patients' thoughts, feelings and behaviors that are obstacles in their
lives and impair their mood. During the treatment, which often lasts about
ten weeks, they are given tasks and exercises to perform on their own.

The factor that proved most significant for the prognosis was the depth
of depression at the start of treatment. In milder depression, better
results were obtained. Therapist support and text-message reminders
increased the proportion of patients who completed the therapy.

"If you're going to use iCBT in health care, the programs have to be
regulated just as well as drugs are, but that's not the case today. With
this study, we're taking a real step forward. First, the study surveys
what's most effective. Second, it provides knowledge of how to design
a program and adapt its composition to patients' problems," Bjo"rkelund
says.

However, iCBT requires continuous therapeutic contact. One reason
is the importance of the therapist being able to see an improvement
within three to four weeks, ensuring that the trend is not in the
wrong direction. Bjo"rkelund stresses the great potential danger
of depression. In severe depression, internet-mediated therapy is inappropriate.

The study shows the danger of using iCBT with programs that include
relaxation therapy. Rather than being beneficial, this may have negative effects, exacerbating depressive symptoms and causing "relaxation-induced anxiety." "For a depressed person, it isn't advisable. Relaxation
programs shouldn't be used as part of depression treatment in health
care," Bjo"rkelund says.

========================================================================== Story Source: Materials provided by University_of_Gothenburg. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Toshi A Furukawa, Aya Suganuma, Edoardo G Ostinelli, Gerhard
Andersson,
Christopher G Beevers, Jason Shumake, Thomas Berger, Florien
Willemijn Boele, Claudia Buntrock, Per Carlbring, Isabella Choi,
Helen Christensen, Andrew Mackinnon, Jennifer Dahne, Marcus
J H Huibers, David D Ebert, Louise Farrer, Nicholas R Forand,
Daniel R Strunk, Iony D Ezawa, Erik Forsell, Viktor Kaldo, Anna
Geraedts, Simon Gilbody, Elizabeth Littlewood, Sally Brabyn,
Heather D Hadjistavropoulos, Luke H Schneider, Robert Johansson,
Robin Kenter, Marie Kivi, Cecilia Bjo"rkelund, Annet Kleiboer,
Heleen Riper, Jan Philipp Klein, Johanna Schro"der, Bjo"rn Meyer,
Steffen Moritz, Lara Bu"cker, Ove Lintvedt, Peter Johansson,
Johan Lundgren, Jeannette Milgrom, Alan W Gemmill, David C Mohr,
Jesus Montero- Marin, Javier Garcia-Campayo, Stephanie Nobis,
Anna-Carlotta Zarski, Kathleen O'Moore, Alishia D Williams, Jill
M Newby, Sarah Perini, Rachel Phillips, Justine Schneider, Wendy
Pots, Nicole E Pugh, Derek Richards, Isabelle M Rosso, Scott L
Rauch, Lisa B Sheeber, Jessica Smith, Viola Spek, Victor J Pop,
Burc,in U"nlu", Kim M P van Bastelaar, Sanne van Luenen, Nadia
Garnefski, Vivian Kraaij, Kristofer Vernmark, Lisanne Warmerdam,
Annemieke van Straten, Pavle Zagorscak, Christine Knaevelsrud,
Manuel Heinrich, Clara Miguel, Andrea Cipriani, Orestis Efthimiou,
Eirini Karyotaki, Pim Cuijpers. Dismantling, optimising, and
personalising internet cognitive behavioural therapy for depression:
a systematic review and component network meta-analysis using
individual participant data. The Lancet Psychiatry, 2021; 8 (6):
500 DOI: 10.1016/S2215-0366 (21)00077-8 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/08/210802115010.htm

--- up 12 weeks, 3 days, 22 hours, 45 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)