Guided and unguided world-wide-web-primarily based cognitive behavioral therapy (iCBT) was productive for the therapy of patients with depression, according to outcomes of a meta-evaluation, published in JAMA Psychiatry.
Researchers from Harvard Medical School searched publication databases via January 2019 for randomized clinical trials (RCTs) of guided or unguided iCBT for adults with depression.
A total of 42 research comprising 9751 study participants performed in 12 nations across Europe, North America, and China have been incorporated. The research compared guided iCBT (n=13) or unguided iCBT (n=15) with manage circumstances of usual care (n=15) or waiting list (n=22). Guided and unguided iCBT have been straight compared with every other in 5 research.
iCBT comprised 5-18 (imply, 8. typical deviation [SD], 2.8) on the internet sessions for 5-14 (imply, 9 SD, 2.5) weeks. Among the research of guided therapy, the guidance was offered by students in clinical psychology (n=14), paraprofessionals or lay therapists (n=6), or licensed psychologists or psychotherapists (n=5).
The Patient Health Questionnaire-9 (PHQ-9) scores indicated guided iCBT more proficiently enhanced symptoms of depression than unguided iCBT (imply distinction [MD], -.8 95% CI, -1.4 to -.2) as properly as the manage circumstances of usual care (MD, -1.7 95% CI, -2.3 to -1.1) or waiting list (MD, -3.3 95% CI, -3.9 to -2.6). Unguided iCBT lowered symptoms of depression compared with the manage circumstances of usual care (MD, -.9 95% CI, -1.5 to -.3) or waiting list (MD, -2.5 95% CI, -3.2 to -1.8).
Among the research with enough lengthy-term adhere to-up, no substantial variations have been observed amongst guided or unguided iCBT at 6 (MD, -.2 95% CI, -.8 to .3) or 12 (MD, .1 95% CI, -.4 to .6) months.
Treatment response was reported by practically half (48%) of guided iCBT recipients and more than a third (37%) of unguided iCBT recipients. Stratified by baseline severity of depressive symptoms, 46% of moderate and 55% of serious patients responded to guided iCBT compared with 39% and 40% to unguided iCBT, respectively.
This study was restricted by not like information on comorbidities, duration of depressive symptoms, or quantity of earlier episodes, all of which might have influenced patients’ response to therapy.
These information indicated that each guided and unguided iCBT was in a position to lessen symptoms of depression for up to 12 months amongst a lot of patients. This low-expense therapy might be a viable therapy alternative for patients with moderate symptoms of depression, escalating access to care.
Disclosure: Multiple authors declared affiliations with market. Please refer to the original write-up for a complete list of disclosures.
Karyotaki E, Efthimiou O, Miguel C, et al. Internet-based cognitive behavioral therapy for depression. A systematic review and individual patient data network meta-analysis. JAMA Psychiatry. Published on the internet January 20, 2021. doi:10.1001/jamapsychiatry.2020.4364.