Adding an Internet-based depression treatment to usual care is about as effective as pharmacologic and psychotherapeutic treatments, according to new data.
“There is a huge treatment gap in depression; many patients who are depressed don’t get treatment, or don’t get adequate treatment,” said Jan Philipp Klein, MD, of Lübeck University’s department of psychiatry and psychotherapy, nodding towards the fact that about 80% of depressed individuals do not seek out professional help.
A number of different, evidence-based Internet interventions have been found to be effective, but only in small sample sizes, none of which included patients with physician-rated disease. With that in mind, Klein and colleagues developed the EffectiVeness of Internet-based DEpressionN Treatment (EVIDENT) trial.
“It can be used as you’re waiting for actual treatment [with a mental health professional],” he said. “It can be used as post-relapse kind of prevention with material that was presented in therapy after therapy. It can be a top-up therapy between [psychotherapy sessions].”
They randomly assigned 1,013 patients suffering from mild to moderate depression symptoms to either strictly the typical treatments, or to the typical treatments in addition to a 12-week Internet intervention program.
According to Klein, the Internet intervention “conveys cognitive behavioral therapy-based information on dealing with depression in a directive manner” by providing info on mindfulness, cognitive work, and behavioral techniques. Patients can then give feedback, telling researchers how they felt about the info.
Klein and the team found that while the symptoms of both groups improved, the group who received the additional Internet intervention treatment experienced greater improvements in their primary outcome.
Now, the researchers’ next step is to find a way to put the Internet intervention treatment into actual practice.
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“The real next step is integrating these treatments into actual clinical practice and actual care because we really have a large evidence base now and we are the first ones to also show that this evidence extends to clinician ratings of depression,” said Klein. “Really, what’s at stake now is implementing this into clinical practice.”