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One-year follow-up results of a randomized controlled clinical trial on internet-based cognitive behavioural therapy for subthreshold depression in people over 50 years

Published online by Cambridge University Press:  21 January 2008

V. Spek ,
P. Cuijpers ,
I. Nyklíček ,
N. Smits ,
H. Riper ,
J. Keyzer  and
V. Pop
V. Spek*
Affiliation:
Department of Psychology and Health, Tilburg University, The Netherlands
P. Cuijpers
Affiliation:
Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
I. Nyklíček
Affiliation:
Department of Psychology and Health, Tilburg University, The Netherlands
N. Smits
Affiliation:
Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
H. Riper
Affiliation:
Trimbos-instituut, Netherlands Institute of Mental Health and Addiction, The Netherlands
J. Keyzer
Affiliation:
Diagnostic Centre Eindhoven, The Netherlands
V. Pop
Affiliation:
Department of Psychology and Health, Tilburg University, The Netherlands
*
*Address for correspondence: Dr V. Spek, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands. (Email: v.r.m.spek@uvt.nl)
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Abstract

Background

Internet-based cognitive behaviour therapy (CBT) is a promising new approach for the treatment of depressive symptoms. The current study had two aims: (1) to determine whether, after 1 year, an internet-based CBT intervention was more effective than a waiting-list control group; and (2) to determine whether the effect of the internet-based CBT differed from the group CBT intervention, 1 year after the start of treatment.

Method

A total of 191 women and 110 men (mean age=55 years, s.d.=4.6) with subthreshold depression were randomized into internet-based treatment, group CBT (Lewinsohn's Coping with Depression Course), or a waiting-list control condition. The main outcome measure was treatment response after 1 year, defined as the difference in pretreatment and follow-up scores on the Beck Depression Inventory (BDI). Missing data were imputed using the multiple imputation procedure of data augmentation. Analyses were performed using multiple imputation inference.

Results

In the waiting-list control group, we found a pretreatment to follow-up improvement effect size of 0.69, which was 0.62 in the group CBT condition and 1.22 with the internet-based treatment condition. Simple contrasts showed a significant difference between the waiting-list condition and internet-based treatment (p=0.03) and no difference between both treatment conditions (p=0.08).

Conclusions

People aged over 50 years with subthreshold depression can still benefit from internet-based CBT 1 year after the start of treatment.

Keywords

Cognitive behaviour therapydepressioninternet
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 635 - 639
Copyright
Copyright © Cambridge University Press 2008

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