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Internet-based CBT for patients with depressive disorders in primary and psychiatric care: Is it effective and does comorbidity affect outcome?
Ctr Clin Res, Sweden.
Orebro Univ, Sweden.
Orebro Univ, Sweden.
Karolinska Inst, Sweden.
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2020 (English)In: Internet Interventions, ISSN 2214-7829, INTERNET INTERVENTIONS-THE APPLICATION OF INFORMATION TECHNOLOGY IN MENTAL AND BEHAVIOURAL HEALTH, Vol. 19, article id UNSP 100303Article in journal (Refereed) Published
Abstract [en]

Internet-based cognitive behavior therapy (ICBT) has proved effective in reducing mild to moderate depressive symptoms. However, only a few studies have been conducted in a regular healthcare setting which limits the generalizability of the results. The influence of psychiatric comorbidity on outcome is not well understood. In the current study, patients with mild to moderate depressive symptoms in primary and psychiatric care were interviewed using the SCID-I and SCID-II to assess psychiatric diagnoses. Those included were randomly allocated to ICBT (n = 48) or to an active control condition (n = 47). Both groups received therapist support. At post-treatment, ICBT had reduced depressive symptoms on the BDI-II more than the active control intervention (p = .021). However, the difference between groups was no longer significant at the 6-, 12- or 24-month followups. The within-group effect size after ICBT (BDI-II) was large (d = 1.4). A comorbid anxiety disorder didnt moderate the outcome, while the presence of a personality disorder predicted significantly less improvement in depressive symptoms. ICBT had a large effect on depressive symptoms in a sample from regular healthcare. It is possible to obtain a large effect from ICBT despite comorbid anxiety, however, including patients with a comorbid personality disorder in the current form of ICBT seems questionable.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 19, article id UNSP 100303
Keywords [en]
Depression; Internet; Comorbidity; Personality disorders; Primary healthcare; Psychiatric care
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-164031DOI: 10.1016/j.invent.2019.100303ISI: 000512973600010PubMedID: 32055451Scopus ID: 2-s2.0-85078071617OAI: oai:DiVA.org:liu-164031DiVA, id: diva2:1411784
Note

Funding Agencies|Region Orebro County Research Committee [OLL-57/06]; Regional Research Council [RFR-73351]

Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-03-25Bibliographically approved

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Andersson, Gerhard
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PsychologyFaculty of Arts and SciencesDepartment of Otorhinolaryngology
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