Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis

被引：226

作者：

Karyotaki, Eirini ^{[1
]}

Ebert, David Daniel ^{[2
]}

Donkin, Liesje ^{[3
]}

Riper, Heleen ^{[1
]}

Twisk, Jos ^{[30
]}

Burger, Simone ^{[1
]}

Rozental, Alexander ^{[4
,29
]}

Lange, Alfred ^{[5
]}

Williams, Alishia D. ^{[6
]}

Zarski, Anna Carlotta ^{[2
]}

Geraedts, Anna ^{[7
]}

van Straten, Annemieke ^{[1
]}

Kleiboer, Annet ^{[1
]}

Meyer, Bjoern ^{[8
,33
]}

Ince, Burgin B. Unlu ^{[9
]}

Buntrock, Claudia ^{[2
]}

Lehr, Dirk ^{[10
]}

Snoek, Frank J. ^{[11
]}

Andrews, Gavin ^{[12
]}

Andersson, Gerhard ^{[13
]}

Choi, Isabella ^{[14
]}

Ruwaard, Jeroen ^{[1
]}

Klein, Jan Philipp ^{[15
]}

Newby, Jill M. ^{[16
,34
,35
]}

Schroder, Johanna ^{[17
,38
]}

Laferton, Johannes A. C. ^{[2
]}

Van Bastelaar, Kim ^{[18
]}

Imamura, Kotaro ^{[19
]}

Vernmark, Kristofer ^{[20
]}

Boss, Leif ^{[10
]}

Sheeber, Lisa B. ^{[21
]}

Kivi, Marie ^{[22
]}

Berking, Matthias ^{[2
]}

Tito, Nickolai ^{[23
]}

Carlbring, Per ^{[36
,37
]}

Johansson, Robert ^{[24
,25
]}

Kenter, Robin ^{[26
]}

Perini, Sarah ^{[32
]}

Moritz, Steffen ^{[1
]}

Nobis, Stephanie ^{[27
]}

Berger, Thomas ^{[28
]}

Kaldo, Viktor ^{[29
,39
]}

Forsell, Yvonne ^{[29
]}

Lindefors, Nils ^{[29
]}

Kraepelien, Martin ^{[29
]}

Bjorkelund, Cecilia ^{[31
]}

Kawakami, Norito ^{[19
]}

Cuijpers, Pim ^{[1
]}

机构：

[1] VU, Amsterdam Publ Hlth Res Inst, Dept Clin Psychol, Amsterdam, Netherlands

[2] Friedrich Alexander Univ Erlangen Nurnberg, Dept Clin Psychol & Psychotherapy, Erlangen, Germany

[3] Univ Sydney, Brain & Mind Res Inst, Sydney, NSW 2050, Australia

[4] UCL, Inst Child Hlth, London, England

[5] Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands

[6] Univ Utrecht, Dept Clin Psychol, Utrecht, Netherlands

[7] HumanTotalCare, Utrecht, Netherlands

[8] Gaia AG, Res Dept, Hamburg, Germany

[9] Middle East Tech Univ, Informat Inst, Ankara, Turkey

[10] Leuphana Univ Luneburg, Inst Psychol, Luneburg, Germany

[11] Vrije Univ Amsterdam Med Ctr, Acad Med Ctr, Publ Hlth Res Inst, Dept Med Psychol, Amsterdam, Netherlands

[12] Univ New South Wales, St Vincents Hosp, Sch Psychiat, Clin Res Unit Anxiety & Depress, Darlinghurst, NSW, Australia

[13] Linkoping Univ, Karolinska Inst Disabil Res, Psychiat Sect, Dept Behav Sci & Learning,Dept Clin Neurosci, Stockholm, Sweden

[14] Univ Sydney, Brain & Mind Ctr, Sydney, NSW, Australia

[15] Luebeck Univ, Dept Psychiat & Psychotherapy, Lubeck, Germany

[16] Univ New South Wales, St Vincents Hosp, Sch Psychiat, Clin Res Unit Anxiety & Depress, Darlinghurst, NSW, Australia

[17] Univ Med Ctr Hamburg Eppendorf, Dept Psychiat & Psychotherapy, Hamburg, Germany

[18] Vrije Univ Amsterdam Med Ctr, Dept Med Psychol, Amsterdam, Netherlands

[19] Univ Tokyo, Grad Sch Med, Sch Publ Hlth, Dept Mental Hlth,Bunkyo Ku, Tokyo, Japan

[20] Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden

[21] Oregon Res Inst, Eugene, OR 97403 USA

[22] Univ Gothenburg, Dept Psychol, Gothenburg, Sweden

[23] Macquarie Univ, Dept Psychol, MindSpot Clin & eCtr Clin, Sydney, NSW, Australia

[24] Linkoping Univ, Dept Behav Sci & Learning, Stockholm, Sweden

[25] Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden

[26] Univ Bergen, Dept Clin Psychol, Bergen, Norway

[27] Leuphana Univ Luneburg, Innovat Incubator, Div Online Hlth Training, Luneburg, Germany

[28] Univ Bern, Dept Clin Psychol & Psychotherapy, Bern, Switzerland

[29] Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden

[30] Vrije Univ Amsterdam, EMGO Inst Hlth & Care Res, Dept Epidemiol & Biostat, Amsterdam, Netherlands

[31] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Primary Hlth Care, Gothenburg, Sweden

[32] St Vincents Hosp, Clin Res Unit Anxiety & Depress, Sydney, NSW, Australia

[33] City Univ London, Dept Psychol, London, England

[34] MRC Cognit & Brain Sci Unit, Cambridge, England

[35] Univ New South Wales, Sch Psychol, Sydney, NSW, Australia

[36] Stockholm Univ, Dept Psychol, Stockholm, Sweden

[37] Univ Southern Denmark, Dept Psychol, Odense, Denmark

[38] Inst Sex Res & Forens Psychiat, Hamburg, Germany

[39] Linnaeus Univ, Fac Hlth & Life Sci, Dept Psychol, Vaxjo, Sweden

来源：

CLINICAL PSYCHOLOGY REVIEW | 2018年 / 63卷

基金：

日本学术振兴会;

关键词：

Internet-based guided self-help; Psychotherapy; Depression; Meta-analysis; RANDOMIZED CONTROLLED-TRIAL; COGNITIVE-BEHAVIOR THERAPY; TO-MODERATE DEPRESSION; RESIDUAL SYMPTOMS; PSYCHOLOGICAL TREATMENTS; MENTAL-DISORDERS; PSYCHIATRIC-DISORDERS; PSYCHOTHERAPY; REMISSION; ANXIETY;

D O I：

10.1016/j.cpr.2018.06.007

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving intemet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.

引用

页码：80 / 92

页数：13

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