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Internet-based self-help for depression: randomised controlled trial

Department of Behavioural Sciences, Linköping University

JAN BERGSTRÖM, MSc

Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm

FREDRIK HOLLÄNDARE, MSc, PER CARLBRING, PhD, VIKTOR KALDO, MSc and LISA EKSELIUS, MD, PhD

Department of Psychology, Uppsala University, Department of Neuroscience, Uppsala University Hospital, Uppsala, Sweden

Correspondence: Professor Gerhard Andersson, Department of Behavioural Sciences, Linköping University, SE-581 83 Linköping, Sweden. Fax: +46 (0) 13 28 21 45; e-mail: Gerhard.Andersson{at}ibv.liu.se

Declaration of interest None. Funding detailed in Acknowledgements.

Background Major depression can be treated by means of cognitive – behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience.

Aims To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only.

Method A randomised controlled trial was conducted to compare the effects of internet-based cognitive–behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only.

Results Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months’ follow-up, improvement was maintained to a large extent.

Conclusions Internet-delivered cognitive cognitive–behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.

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