J. Med. Internet Res. - Multimodal e-mental health treatment for depression: a feasibility trial.


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CKGROUND: Internet interventions for depression have shown less than optimal adherence. This study describes the feasibility trial of a multimodal e-mental health intervention designed to enhance adherence and outcomes for depression. The intervention required frequent brief log-ins for self-monitoring and feedback as well as email and brief telephone support guided by a theory-driven manualized protocol.OBJECTIVE: The objective of this feasibility trial was to examine if our Internet intervention plus manualized telephone support program would result in increased adherence rates and improvement in depression outcomes.METHODS: This was a single arm feasibility trial of a 7-week intervention.RESULTS: Of the 21 patients enrolled, 2 (9.5%) dropped out of treatment. Patients logged in 23.2 ? 12.2 times over the 7 weeks. Significant reductions in depression were found on all measures, including the Patient Health Questionnaire depression scale (PHQ-8) (Cohen's d = 1.96, P < .001), the Hamilton Rating Scale for Depression (d = 1.34, P < .001), and diagnosis of major depressive episode (P < .001).CONCLUSIONS: The attrition rate was far lower than seen either in Internet studies or trials of face-to-face interventions, and depression outcomes were substantial. These findings support the feasibility of providing a multimodal e-mental health treatment to patients with depression. Although it is premature to make any firm conclusions based on these data, they do support the initiation of a randomized controlled trial examining the independent and joint effects of Internet and telephone administered treatments for depression.

Resumo Limpo

ckground internet intervent depress shown less optim adher studi describ feasibl trial multimod ement health intervent design enhanc adher outcom depress intervent requir frequent brief login selfmonitor feedback well email brief telephon support guid theorydriven manual protocolobject object feasibl trial examin internet intervent plus manual telephon support program result increas adher rate improv depress outcomesmethod singl arm feasibl trial week interventionresult patient enrol drop treatment patient log time week signific reduct depress found measur includ patient health questionnair depress scale phq cohen d p hamilton rate scale depress d p diagnosi major depress episod p conclus attrit rate far lower seen either internet studi trial facetofac intervent depress outcom substanti find support feasibl provid multimod ement health treatment patient depress although prematur make firm conclus base data support initi random control trial examin independ joint effect internet telephon administ treatment depress

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