Abstract
BackgroundDepression is a highly prevalent mental health issue that exacts significant economic, societal, personal, and interpersonal costs. Innovative internet-delivered interventions have been designed to increase accessibility to and cost-effectiveness of treatments. These treatments have mainly targeted mild to moderate levels of depression. The increased risk associated with severe depression, particularly of suicidal ideation often results in this population being excluded from research studies. As a result, the effectiveness of internet-delivered cognitive behavioral therapy (iCBT) in more severely depressed cohorts is less researched.ObjectiveThe aim of this study is to examine the effect of iCBT on symptoms of severe depression, comorbid symptoms of anxiety, and levels of work and social functioning.MethodsRetrospective consent was provided by participants with elevated scores (>28 severe depression symptoms) on the Beck Depression Inventory (BDI-II) who accessed an iCBT intervention (Space from Depression) with support for up to 8 weeks. Data were collected at baseline, posttreatment, and 3-month follow-up on the primary outcome (BDI-II), and secondary outcomes (the Generalized Anxiety Disorder-7 and the Work and Social Adjustment Scale).ResultsA significant change was observed on all measures between pre- and postmeasurement and maintained at 3-month follow-up. Clinical improvement was observed for participants on the BDI-II from pre- to postmeasurement, and suicidal ideation also reduced from pre- to postmeasurement.ConclusionsUsers of Space from Depression with symptoms of severe depression were found to have decreased symptoms of depression and anxiety and increased levels of work and social functioning. The intervention also demonstrated its potential to decrease suicidal ideation. Further investigation is required to determine why some individuals improve, and others do not. iCBT may have the potential to be used as an adjunct treatment for severe depression symptoms, but participants may require further treatment if they receive iCBT as a standalone intervention. Although promising, further research incorporating control groups is needed to support the utility of Space from Depression for use in or as an adjunct to treatment for severe depression.
Highlights
BackgroundDepression is a serious public health concern and is predicted to be the leading cause of disability in the world by 2030 [1]
This study aims to explore the effect of the SilverCloud internet-delivered cognitive behavioral therapy (iCBT) intervention on those with severe depression
No significant differences were observed between the BDI-II, Generalized Anxiety Disorder-7 item inventory (GAD-7), and Work and Social Adjustment Scale (WSAS) using t tests between the overall cohort with severe depression (N=211) and those who consented (n=67) to having their posttreatment and follow-up data included in the analysis
Summary
BackgroundDepression is a serious public health concern and is predicted to be the leading cause of disability in the world by 2030 [1]. Depression exacts significant economic, societal, personal, and interpersonal costs [2] Numerous interventions, both psychological [3] and pharmacological [4], have been implemented to reduce its prevalence. Accessing evidence-based psychological interventions can be difficult because of the many barriers [8,9], including not having access to treatment due to a lack of health service resources [8]. These barriers can be more pronounced for severe depression [10], and most individuals with severe levels of depression do not receive adequate treatment [11]. Further research incorporating control groups is needed to support the utility of Space from Depression for use in or as an adjunct to treatment for severe depression
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