Abstract
BackgroundA recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression.AimsTo examine the clinical outcomes and the effect of automated emails at 12 months post-treatment.MethodParticipants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7).ResultsSignificant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70).ConclusionsThe overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes.Trial RegistrationAustralian and New Zealand Clinical Trials Registry ACTRN12610001058066
Highlights
Self-guided internet-delivered psychological interventions for anxiety and depressive disorders have considerable public health potential
Significant improvements in symptoms of anxiety and depression were observed over time in both the Treatment Plus Automated Emails Group (TEG) and Treatment Group (TG) (Fs .69, ps,.001) these were sustained from post-treatment to 12-month follow-up, and were associated with large effect sizes
The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes
Summary
Self-guided internet-delivered psychological interventions for anxiety and depressive disorders have considerable public health potential. While no overall differences in symptom improvement were found between the Treatment Groups, a subgroup of participants with comorbid anxiety and depression, that is, participants with elevated symptoms of both anxiety and depression, obtained superior reductions in symptoms when they received automated emails compared to when they did not receive the emails. The pattern of these results was sustained at 3-month follow-up. A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. It found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression
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