Internet-based CBT Effective in Mild to Moderate Depression, Review Finds

SAN DIEGO—Cognitive behavioral therapy (CBT) delivered through interactive online modules reduces some depressive symptoms for up to 6 months, and can be an effective tool for patients with limited access to mental health care, researchers said Saturday at the annual American Psychiatric Association meeting.

University of Maryland psychiatry residents became interested in CBT delivered via the internet after observing many patients with depressive symptoms in medical hospital units for long periods of time. They did not have the resources to deliver daily or weekly in-person CBT, but realized that nearly all of the patients had access to a computer.

“We decided to look at what’s available online to have patients do something so that they’re not bored in their bed and can also do something that’s going to help them in the long run,” said presenter Charles Koransky, MD.

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In a meta-analysis, researchers reviewed 14 randomized controlled trials involving adults with mild to moderate depression who received iCBT and a control group of people placed on a waitlist.

They found that iCBT had a medium effect on reduction of depressive symptoms during the study periods, and had a large effect in maintaining reduction of symptoms over 3 to 6 months.

The research team also analyzed the differences in effect size between online programs that clinicians participated in and those without clinician assistance, and found no statistically significant difference.

“CBT delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable to access traditional face-to-face therapy,” the researchers concluded.

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Limitations of the study included: participants in the study were sought out through advertisements, and thus may have been highly motivated to improve their symptoms; all of the studies were in Europe and Australia; and there was no uniformity between the programs.

Dr. Koransky iCBT research will be conducted in the United States in the future and include patients recruited from primary care offices.

He said iCBT—which is different from telepsychiatry—could benefit people who do not have access to mental health care, such as residents in rural areas.

“It’s a really promising field that could really increase access and overall well-being for the population,” Dr. Koransky said.

—Terri Airov

Reference

“Efficacy of Cognitive Behavior Therapy Delivered Over the Internet for Depressive Symptoms.” Abstract presented at: the American Psychiatric Association Annual Meeting; May 20, 2017; San Diego, CA.