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Internet-Delivered Disease Management for Recurrent Depression: A Multicenter Randomized Controlled Trial
- Background: Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals. Methods: Efficacy was tested in a 3-arm, multicenter, open-label, evaluator-blind, randomized controlled trial. Upon discharge from inpatient mental health care, 232 adults with 3 or more major depressive episodes were randomized to 1 of 2 intervention groups (SUMMIT or SUMMIT-PERSON) or to treatment as usual (TAU) alone. Over 12 months, participants in both intervention arms received, in addition to TAU, intense monitoring via e-mail or a smartphone, including signaling of upcoming crises, assistance with personal crisis management, and facilitation of early intervention. SUMMIT-PERSON additionally offered regular expert chats. The primary outcome was ‘well weeks', i.e. weeks with at most mild symptoms assessed by the Longitudinal Interval Follow-Up Evaluation, during 24 months after the index treatment. Results: SUMMIT compared to TAU reduced the time with an unwell status (OR 0.48; 95% CI 0.23-0.98) through faster transitions from unwell to well (OR 1.44; 95% CI 0.83-2.50) and slower transitions from well to unwell (OR 0.69; 95% CI 0.44-1.09). Contrary to the hypothesis, SUMMIT-PERSON was not superior to either SUMMIT (OR 0.77; 95% CI 0.38-1.56) or TAU (OR 0.62; 95% CI 0.31-1.24). The efficacy of SUMMIT was strongest 8 months after the intervention. Conclusions: The fully automated Internet-delivered augmentation strategy SUMMIT has the potential to improve TAU by reducing the lifelong burden of patients with recurrent depression. The fact that the effects wear off suggests a time-unlimited extension.
Author: | Hans Kordy, Markus Wolf, Kai Aulich, Martin Bürgy, Ulrich Hegerl, Johannes Hüsing, Bernd Puschner, Christine Rummel-Kluge, Helmut Vedder, Matthias Backenstrass |
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URN: | urn:nbn:de:gbv:9-opus-30941 |
URL: | http://www.karger.com/pps |
DOI: | https://doi.org/10.1159/000441951 |
ISSN: | 0033-3190 |
ISSN: | 1423-0348 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/26808817 |
Parent Title (English): | Psychotherapy and Psychosomatics |
Publisher: | S. Karger AG |
Place of publication: | Basel, Switzerland |
Document Type: | Article |
Language: | English |
Date of first Publication: | 2016/01/26 |
Release Date: | 2020/09/29 |
Tag: | Disease management; Efficacy; Internet; Monitoring; Recurrent depression |
GND Keyword: | - |
Volume: | 85 |
Issue: | 2 |
First Page: | 91 |
Last Page: | 98 |
Faculties: | Universitätsmedizin / Klinik für Psychiatrie und Psychotherapie |
Licence (German): | Urheberrechtlich geschützt |