Internet-based interventions have b...

Internet-based interventions have been effective in patients with symptoms of panic and anxiety, moreover the only reported randomized controll trial of Web-based treatment for depression raise modest effect that was limited to patients with mild symptoms. Christensen and colleagues used Web-based programs to compare the validity of sites providing psychoeducation with those offering cognitive-behavior therapy in Australian patients with significant depressive symptoms.

They used a randomly mailed community scrutinize to identify volunteers who were not receiving psychologic care yet had significant depressive symptoms (Kessler psychologic distress score of 22 or more) and had access to the Internet. More than 500 participants were assigned randomly to the psychoeducation, cognitive-behavior therapy, or ascendency groups of the study. The psychoeducation site (BluePages, http://bluepages.anu.edu.au) focused in succession information about depression, including evidence-based discussions of treatment. The cognitive-behavior site (MoodGYM http://moodgym.anu.edu.au) provided therapy for prevention of depression. The 165 and 182 patients assigned to these respective Web sites were sent detailed guides for using their site and weekly assignments. Lay interviewers contacted the participants weekly. With all participants, the lay interviewers discussed lifestyle and environmental factors influencing depressive symptoms, as it was as physical activity, hobbies, family issues, financial belong tos medications, alcohol use, and symptoms experienced, especially pain.

In patients assigned to the treatment arranges the interviewers also assisted in use of the Web sites. The main issues assessed by the study were a self-reported 20-item depression scale and a questionnaire about dysfunctional thinking. The issues in the two intervention form into groupss were compared with those of 178 have the direction of patients who received only weekly contact with a lay interviewer.

The three clusters were comparable in all important variables, including depression and psychologic distress scores at the beginning of the close attention Web logs indicated that participants in the BluePages cluster visited the site an average of 449 times, and that MoodGYM participants complet an average of undivided half of the 29 exercises. After six weeks, one as well as the other groups assigned to Web interventions showed significant reductions in depressive symptoms compared with the check group and with baselines. Compared with the direction group, dysfunctional thinking significantly improved in participants assigned to MoodGYM nevertheless not in those assigned to BluePages. reciprocally knowledge of interventions for depression significantly improved alone in participants assigned to BluePages. Participants reported high rates of satisfaction with the interventions, which included ease of use of the Web sites and over-all satisfaction with the interview process

The authors judge that Internet-based interventions can be effective in pick out community-based patients with significant depression.

EDITOR'S NOTE: In practice, modified cognitive-behavior therapy can be a highly effective treatment or adjunctive therapy for depression. Although it is professionally rewarding to coach patients by the and of development of more realistic thinking and effective approaches to life, this therapy is demanding upon the time and energy of the physician. This thought indicates that well-selected Web sites could be used to unfold a more independent role for patients and hem ins out the prospect of achieving useful results with fewer demands forward physicians. Patients must be cautioned, however, that not all Web sites are helpful or provide valid clinical advice.

Christensen H et al. Delivering interventions for depression by means of using the internet: randomised controll trial. BMJ January 31 2004;328:265-9

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