Low intensity vs. self-guided internet-delivered psychotherapy for major depression: a multicenter, controlled,...

Area of Science:

• Psychiatry
• Digital Health
• Health Services Research

Background:

• Major depression is a leading cause of disability globally.
• Computerized cognitive-behavioral therapy (cCBT) offers a potential efficacious and cost-effective treatment option.
• There is a lack of cost-effectiveness studies comparing low-intensity versus self-guided psychotherapy for depression.

Purpose of the Study:

• To assess the efficacy of low-intensity versus self-guided internet-delivered psychotherapy for major depression.
• To evaluate these interventions within the context of the Spanish National Health System.
• To conduct a comparative economic evaluation against usual care.

Main Methods:

• Development of a tailored cCBT program for the Spanish health system.
• A multicenter, randomized controlled trial with 450 mild/moderate depression patients.
• Three treatment arms: low-intensity internet-delivered psychotherapy + usual care, self-guided internet-delivered psychotherapy + usual care, and usual care alone.

Main Results:

• Patients were assessed at baseline, 3, and 12 months using the Beck Depression Inventory, EuroQol 5D, and Client Service Receipt Inventory.
• Intention-to-treat and per-protocol analyses were performed.
• The study provides data on efficacy and cost-effectiveness of digital mental health interventions.

Conclusions:

• Comparisons between low-intensity and self-guided internet-delivered psychotherapy are infrequent.
• This study offers a comparative economic evaluation of these digital interventions against usual care in primary care.
• The research is strengthened by its multicenter, randomized controlled trial design, integrating digital therapy into primary care.