J. Med. Internet Res. - Effectiveness of a web-based solution-focused brief chat treatment for depressed adolescents and young adults: randomized controlled trial.

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Resumo

CKGROUND: Up to 9% of young people suffer from depression. Unfortunately, many in need of help remain untreated. The Internet offers anonymous ways to help depressed youth, especially those who are reluctant to search for help because of fear of stigma.OBJECTIVE: Our goal was to evaluate the effectiveness of an individual chat treatment based on Solution-Focused Brief Therapy (SFBT) to young individuals aged 12-22 years with depressive symptoms by comparing it to a waiting list control group.METHODS: For this study, 263 young people with depressive symptoms were randomized to the Web-based SFBT intervention, PratenOnline, or to a waiting list control condition. The chat treatment was delivered by trained professionals. Groups were compared on depressive complaints as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) after 9 weeks and 4.5 months. For the chat group only, changes in depressive symptoms at 7.5 months after baseline were explored.RESULTS: The experimental SFBT condition (n=131) showed significantly greater improvement than the waiting list condition (n=132) in depressive symptoms at 9 weeks and 4.5 months on the CES-D, with a small between group effect size at 9 weeks (d=0.18, 95% CI -0.10 to 0.47) and a large effect size at 4.5 months (d=0.79, 95% CI 0.45-1.08). The percentage of participants showing a reliable and clinically significant change in depression was significantly larger for the SFBT intervention at 4.5 months only (28.2% vs 11.4% for the waiting list, P<.001, number needed to treat=6). At 7.5 months, the SFBT group showed further improvements. However, results have to be considered carefully because of high attrition rates.CONCLUSIONS: The Web-based SFBT chat intervention of PratenOnline was more effective than a waiting list control group in reducing depressive symptoms, and effects were larger at follow-up then at post-treatment. More studies are needed to find out if outcomes will be replicated, especially for those younger than 18 year old.TRIAL REGISTRATION: Netherlands Trial Register: NTR 1696; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1696 (Archived by WebCite at http://www.webcitation.org/6DspeYWrJ).

Resumo Limpo

ckground young peopl suffer depress unfortun mani need help remain untreat internet offer anonym way help depress youth especi reluct search help fear stigmaobject goal evalu effect individu chat treatment base solutionfocus brief therapi sfbt young individu age year depress symptom compar wait list control groupmethod studi young peopl depress symptom random webbas sfbt intervent pratenonlin wait list control condit chat treatment deliv train profession group compar depress complaint measur center epidemiolog studi depress scale cesd week month chat group chang depress symptom month baselin exploredresult experiment sfbt condit n show signific greater improv wait list condit n depress symptom week month cesd small group effect size week d ci larg effect size month d ci percentag particip show reliabl clinic signific chang depress signific larger sfbt intervent month vs wait list p number need treat month sfbt group show improv howev result consid care high attrit ratesconclus webbas sfbt chat intervent pratenonlin effect wait list control group reduc depress symptom effect larger followup posttreat studi need find outcom will replic especi younger year oldtrial registr netherland trial regist ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgdspeywrj

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