Abstract

BackgroundDuring the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives. The main objective of this double-blind, randomized controlled trial is to examine the efficacy of an internet-based self-management tool (iFightDepression) for mild to moderate depression as an add-on to treatment as usual (TAU) versus internet-based psychoeducation plus TAU.MethodsA total of 310 participants with major depression disorder (MDD) will be recruited at four different mental-health facilities in Spain. Participants will be randomly allocated to one of two study arms: iFightDepression (iFD) tool + TAU vs. internet-based psychoeducation + TAU. Both interventions last for 8 weeks and there is a 12 weeks follow up. The primary outcome measure is changes in depressive symptoms assessed with the Hamilton Depression Rating Scale. Additionally, pre-post interventions assessments will include socio-demographic data, a brief medical and clinical history and self-reported measures of depressive symptoms, quality of life, functional impairments and satisfaction with the iFD tool.DiscussioniFightDepression is an easy-prescribed tool that could increase the efficacy of conventional treatment and potentially reach untreated patients, shortening waiting lists to receive psychological treatment. Confirming the efficacy of the iFD internet-based self-management tool as an add-on treatment for individuals with mild to moderate depression will be clinically-relevant.Trial registrationRegistration number NCT02312583. Clinicaltrials.gov. December 4, 2014.

Highlights

  • During the last decade online interventions have emerged as a promising approach for patients with mild/moderate depressive symptoms, reaching at large populations and representing cost-effective alternatives

  • Most internet-based treatments are framed in cognitive behavioral therapy (CBT) and are developed to treat individuals with mild to moderate depressive symptoms that are usually visited in primary care settings

  • Note: Mini-International Neuropsychiatric Interview (MINI) Mine-international Neuropsychiatric Interview, HDRS Hamilton Depression Rating Scale, Patient health questionnaire (PHQ-9) Patient health Questionnaire, Clinical global impression - severity (CGI-S) Clinical Global Impression-Severity, CGI-I Clinical Global Impression-Improvement, Remission from depression questionnaire (RDQ) Remission from Depression Questionnaire, functioning assessment short test (FAST) Functioning Assessment Short Test instrument is composed of two parts

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Summary

Methods

Design We designed an 8-week, double-blind, randomized controlled trial, with two treatment arms: iFightDepression tool + TAU and internet-based psychoeducation + TAU. Randomization will be performed electronically by an independent study researcher Participants in both treatment arms will be followed via internet during a 12-week period. The intervention group will receive a telephone call to make sure that participants activated successfully their user accounts They will be contacted bi-weekly by a mental health professional (specialized nurse or psychologist), to work through the material and to provide technical support). Active control group (internet-based psychoeducation + TAU) Internet-based psychoeducation consists of a webpage containing information about MDD and healthy habits This webpage (www.ifightdepression.com) was designed by the EAAD consortium, and unlike the tool, workshops and tasks are lacking. What is depression, signs and symptoms, diagnosing depression, subtypes of depression, brain function in depression, causes and an overview of depressions treatment (both pharmacological and psychological) Participants on this condition can complete the online PHQ-9.

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