Abstract
BackgroundDepression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. Knowledge regarding the options of combining online self-help with inpatient psychotherapy is still limited. Therefore, we plan to evaluate an evidence-based self-help program (deprexis®; Gaia AG, Hamburg, Germany) to improve the efficacy of inpatient psychotherapy and to maintain treatment effects in the aftercare period.Methods/designDepressed patients (n = 240) with private internet access aged between 18 and 65 are recruited during psychosomatic inpatient treatment. Participants are randomized to an intervention or control group at the beginning of inpatient treatment. The intervention group (n = 120) is offered an online self-help program with 12 weekly tasks, beginning during the inpatient treatment. The control group (n = 120) obtains access to an online platform with weekly updated information on depression for the same duration. Assessments are conducted at the beginning (T0) and the end of inpatient treatment (T1), at the end of intervention (T2) and 6 months after randomization (T3). The primary outcome is the depression score measured by the Beck Depression Inventory-II at T2. Secondary outcome measures include anxiety, self-esteem, quality of life, dysfunctional cognitions and work ability.DiscussionWe expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up. This could be an important approach to develop future concepts of inpatient psychotherapy.Trial registrationClinicalTrials.gov Identifier: NCT02196896 (registered on 16 July 2014).
Highlights
Depression is one of the most debilitating and costly mental disorders
We expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up
Self-report questionnaires (BDI-II, Patient Health Questionnaire (PHQ)-9, Generalized Anxiety Screener (GAD)-7, Rosenberg Self-Esteem Scale (RSE), EUROHIS-QOL 8, Dysfunctional Attitude Scale (DAS), Work Ability Index (WAI), Helping Alliance Questionnaire (HAQ)) will be analyzed by analysis of covariance All analyses will be conducted on a two-sided level of significance of 0.05
Summary
Depression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. There have been many efforts to deliver online interventions, which have the potential to be widely available It is still unclear if and how people use the internet if they have mental health problems. In two recent meta analyses effect sizes have been reported, with small effects for the difference between self-guided psychological treatment of depression and control groups (d = 0.28, seven randomized controlled trials [3]) and moderate effects (d = 0.56; 19 studies [4]) for the post-treatment effects For anxiety disorders another meta-analysis found an overall effect size of Zwerenz et al Trials (2015) 16:98 computer-aided psychotherapy compared with noncomputer-aided psychotherapy of d = 1.08 (23 randomized controlled trials [5]). A considerable number of studies and meta-analyses have found that guided self-help for depression is effective compared to untreated control conditions [3] and that it may be as effective as face-to-face treatments [5,6]
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