Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials.
Psychother Psychosom
; 90(2): 94-106, 2021.
Article
en En
| MEDLINE
| ID: mdl-32544912
ABSTRACT
INTRODUCTION:
Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent.OBJECTIVE:
We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes.METHODS:
Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators.RESULTS:
Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment 6-12 weeks; Hedges' g = 0.39 [95% CI 0.25-0.53]; follow-up 1 3-6 months; g = 0.30 [95% CI 0.15-0.45]; follow-up 2 12 months, g = 0.27 [95% CI 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS.CONCLUSIONS:
Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trastorno Depresivo Mayor
/
Intervención basada en la Internet
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
/
Systematic_reviews
Límite:
Adult
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Aged
/
Humans
Idioma:
En
Revista:
Psychother Psychosom
Año:
2021
Tipo del documento:
Article
País de afiliación:
Alemania