Please use this identifier to cite or link to this item:
https://ahro.austin.org.au/austinjspui/handle/1/25679| Title: | Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis. | Austin Authors: | Karyotaki, Eirini;Efthimiou, Orestis;Miguel, Clara;Bermpohl, Frederic Maas Genannt;Furukawa, Toshi A;Cuijpers, Pim;Riper, Heleen;Patel, Vikram;Mira, Adriana;Gemmill, Alan W ;Yeung, Albert S;Lange, Alfred;Williams, Alishia D;Mackinnon, Andrew;Geraedts, Anna;van Straten, Annemieke;Meyer, Björn;Björkelund, Cecilia;Knaevelsrud, Christine;Beevers, Christopher G;Botella, Cristina;Strunk, Daniel R;Mohr, David C;Ebert, David D;Kessler, David;Richards, Derek;Littlewood, Elizabeth;Forsell, Erik;Feng, Fan;Wang, Fang;Andersson, Gerhard;Hadjistavropoulos, Heather;Christensen, Heleen;Ezawa, Iony D;Choi, Isabella;Rosso, Isabelle M;Klein, Jan Philipp;Shumake, Jason;Garcia-Campayo, Javier;Milgrom, Jeannette ;Smith, Jessica;Montero-Marin, Jesus;Newby, Jill M;Bretón-López, Juana;Schneider, Justine;Vernmark, Kristofer;Bücker, Lara;Sheeber, Lisa B;Warmerdam, Lisanne;Farrer, Louise;Heinrich, Manuel;Huibers, Marcus J H;Kivi, Marie;Kraepelien, Martin;Forand, Nicholas R;Pugh, Nicky;Lindefors, Nils;Lintvedt, Ove;Zagorscak, Pavle;Carlbring, Per;Phillips, Rachel;Johansson, Robert;Kessler, Ronald C;Brabyn, Sally;Perini, Sarah;Rauch, Scott L;Gilbody, Simon;Moritz, Steffen;Berger, Thomas;Pop, Victor;Kaldo, Viktor;Spek, Viola;Forsell, Yvonne | Affiliation: | Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden Research Department, Gaia AG, Hamburg, Germany Department of Psychology, City, University of London, London, England Department of Psychology, University of New South Wales, Sydney, New South Wales, Australia PROMOSAM Excellence in Research Program, MINECO, Valencia, Spain Department of Personality, Evaluation and Psychological Treatment, Valencia University, Valencia, Spain Department of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands Amsterdam Public Health Research Institute, Amsterdam, the Netherlands Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, Amsterdam, the Netherlands Amsterdam Public Health Research Institute, Amsterdam, the Netherlands Department of Clinical Psychology and Psychotherapy, University of Wuppertal, Wuppertal, Germany Department of Health Promotion and Human Behavior, Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland Department of Psychiatry, University of Oxford, Oxford, England Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts Prince of Wales Hospital, Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia Center for Mental Health, University of Melbourne, Melbourne, Victoria, Australia Parent-Infant Research Institute Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden Psykologpartners, Linkoping, Sweden Department of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellon, Spain CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain Aragon Institute for Health Research (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain Primary Care Prevention and Health Promotion Research Network, RedIAPP, Madrid, Spain McLean Hospital, Belmont, Massachusetts Harvard Medical School, Boston, Massachusetts E-mental Health Research Group, Trinity College Dublin School of Psychology, Dublin, Ireland Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland Centre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol, England National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England Centre for Mental Health Research, The Australian National University, Canberra, Australia Central Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden Department of Health Sciences, University of York, York, England Hull York Medical School, University of York, York, England The Clinical Psychology Centre, Sydney, New South Wales, Australia Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York Department of Clinical Psychology and Psychotherapy, University of Wuppertal, Wuppertal, Germany Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts Depression Clinical and Research Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands HumanTotalCare, Utrecht, the Netherlands Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg School of Public Health and Community Medicine, Gothenburg, Sweden Department for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin Department of Psychology, The Ohio State University, Columbus, Ohio Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, Illinois Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany Department of Health Sciences, University of York, York, England Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden Benson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts Department of Psychology and Sleep Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China Department of Psychology, University of Regina, Regina, Saskatchewan, Canada Department of Psychology, The Ohio State University, Columbus, Ohio Department of Psychiatry and Psychotherapy, Luebeck University, Luebeck, Germany Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin Imperial Clinical Trials Unit, Imperial College London, London, England Warneford Hospital, Department of Psychiatry, University of Oxford, Oxford, England Institute of Mental Health, University of Nottingham, Nottingham, England Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Oregon Research Institute, Eugene, Oregon National Health Care Institute, Diemen, the Netherlands Department for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany Department of Psychology and AgeCap, University of Gothenburg, Gothenburg, Sweden Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden Department of Psychology, University of Regina, Regina, Saskatchewan, Canada Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden Norwegian Center for E-health research, Tromsø, Norway Department for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany Department of Psychology, Stockholm University, Stockholm, Sweden Faculty of Medicine, Imperial College London School of Public Health, London, England Department of Psychology, Stockholm University, Stockholm, Sweden Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland McLean Hospital, Belmont, Massachusetts Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland Department of Clinical and Medical Health Psychology, Tilburg University, Tilburg, the Netherlands Section of Epidemiology and Public Health Intervention Research, Department of Global Public Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden Clinical and Health Psychology |
Issue Date: | 2021 | Date: | 2021-01-20 | Publication information: | JAMA psychiatry 2021; 78(4): 361-371 | Abstract: | Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depression using patient-level information. We searched PubMed, Embase, PsycInfo, and Cochrane Library to identify randomized clinical trials (RCTs) published up to January 1, 2019. Eligible RCTs were those comparing guided or unguided iCBT against each other or against any control intervention in individuals with depression. Available individual patient data (IPD) was collected from all eligible studies. Depression symptom severity was assessed after treatment, 6 months, and 12 months after randomization. We conducted a systematic review and IPD network meta-analysis and estimated relative treatment effect sizes across different patient characteristics through IPD network meta-regression. Patient Health Questionnaire-9 (PHQ-9) scores. Of 42 eligible RCTs, 39 studies comprising 9751 participants with depression contributed IPD to the IPD network meta-analysis, of which 8107 IPD were synthesized. Overall, both guided and unguided iCBT were associated with more effectiveness as measured by PHQ-0 scores than control treatments over the short term and the long term. Guided iCBT was associated with more effectiveness than unguided iCBT (mean difference [MD] in posttreatment PHQ-9 scores, -0.8; 95% CI, -1.4 to -0.2), but we found no evidence of a difference at 6 or 12 months following randomization. Baseline depression was found to be the most important modifier of the relative association for efficacy of guided vs unguided iCBT. Differences between unguided and guided iCBT in people with baseline symptoms of subthreshold depression (PHQ-9 scores 5-9) were small, while guided iCBT was associated with overall better outcomes in patients with baseline PHQ-9 greater than 9. In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression, benefits were more substantial in individuals with moderate to severe depression. Unguided iCBT was associated with similar effectiveness among individuals with symptoms of mild/subthreshold depression. Personalized treatment selection is entirely possible and necessary to ensure the best allocation of treatment resources for depression. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/25679 | DOI: | 10.1001/jamapsychiatry.2020.4364 | Journal: | JAMA Psychiatry | PubMed URL: | 33471111 | Type: | Journal Article |
| Appears in Collections: | Journal articles |
Show full item record
Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.