Internet-based treatment of depressive symptoms in a Kurdish population: A randomized controlled trial.

OBJECTIVE: Kurdish immigrants in Sweden have a doubled risk of mental health problems, and refugee and immigrant populations underutilize mental health services. The present study investigated the efficacy of culturally adapted guided internet-based cognitive behavior therapy (ICBT) for depressive symptoms in a Kurdish population. METHOD: We included 50 individuals who were randomized to either an 8-week treatment or a wait-list. The Beck Depression Inventory-II was the primary outcome measure, and measures of anxiety and insomnia were secondary outcomes. RESULTS: Depressive symptoms were significantly reduced (intention-to-treat analysis) in the treatment group, with a between-group effect size at posttreatment of Cohen's d = 1.27. Moderate to large between-group effects were also observed on all secondary outcome measures. Treatment effects were sustained at 11-month follow-up. CONCLUSION: The results provide preliminary support for culturally adapted ICBT as a complement to other treatment formats for treating symptoms of depression in a Kurdish population.

ASK FOR IT: An Internet-based educational program for patients with atrial fibrillation - Results from a pilot study and design of the randomized, controlled, multicenter ASK FOR IT study.

Background: In the structured care of patients with atrial fibrillation (AF), education is compulsory. Patients search for information but sources of reliable information are sparse. ASK FOR IT, an internet- and guideline-based educational program, offers such information. Objective: To describe the development of ASK FOR IT, report on a pilot study, and present the design of a randomized controlled trial evaluating the benefits of ASK FOR IT in addition to standard care on symptoms, health-related quality of life (HRQoL), and health economy. Methods: ASK FOR IT was developed by healthcare providers, patients, and a psychologist. ASK FOR IT contains 6 parts: basic mechanisms, symptoms, treatment options, diagnostic possibilities, lifestyle management, and a mental support section. The following questionnaires were used: SF-36, EQ-5D, the disease-specific ASTA (symptoms and HRQoL), and HADS (depression and anxiety). Interviews regarding usability and understanding were conducted. Results: Pilot study: Fifteen patients (mean age 65 years), 4 women and 11 men, took part in the study. During follow-up, the patients improved regarding symptoms in ASTA (P = .038) and the HRQoL mental domain (P = .011), while no differences were seen in SF-36, EQ-5D, or HADS. Interviews indicated that the program was easy to use and the content easy to understand. Conclusion: The ASK FOR IT program functioned as intended. It was easy to use and the information was easy to understand. The significant reduction in symptoms and improvement in HRQoL (mental domain) after only 3 months are encouraging. In the main study, 200 patients will be randomized.