Individuals who utilized self-guided internet-based cognitive behavioral therapy exhibited improvements in depressive symptoms and had better treatment response.
“Self-guided internet-based cognitive behavioral therapy (iCBT) without therapist support can allow physicians, such as general practitioners, to provide easy and affordable access to psychological treatments and reduce the cost of such treatments,” Eirini Karyotaki, MSc, of Vrije Universiteit Amsterdam, and colleagues wrote. “A meta-analysis found a small but significant effect size of self-guided iCBT compared with control conditions. However, recent large trials found a range of effects, varying from small to moderate effect sizes to no effect.”
To assess efficacy of self-guided iCBT for depressive symptoms in adults, researchers conducted a systematic review and meta-analysis of 13 randomized clinical trials that compared self-guided iCBT with a control. Final analysis included 3,876 study participants with a mean age of 42 years.
Self-guided iCBT was significantly more effective for depressive symptom severity (P < .001) and treatment response (P < .001).
Adherence to treatment was associated with lower depressive symptoms (P = .001) and greater treatment response (P < .001) among participants who received iCBT.
Sociodemographic, clinical and study-level characteristics did not moderate treatment outcomes.
“The findings of the present [individual participant data] meta-analysis suggest that self-guided iCBT may be a viable alternative to current first-step treatment approaches for symptoms of depression, particularly in those individuals who are not willing to have any therapeutic contact,” the researchers wrote. “This form of intervention seems to be valuable for patients with primary depressive problems and those with depressive symptoms in the context of a primary somatic problem. This self-help form of CBT can provide treatment access at low cost to large numbers of individuals worldwide who have depressive symptoms.” – by Amanda Oldt
Disclosure: Karyotaki reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.