An Internet-Based Intervention for Depression in Primary Care in Spain: A Randomized Controlled Trial

Area of Science:

• Mental Health
• Digital Health
• Primary Care Research

Background:

• Depression is a leading cause of global disability.
• Traditional face-to-face therapy for depression faces challenges.
• Internet-based psychological interventions offer a feasible alternative.

Purpose of the Study:

• To compare the effectiveness of a low-intensity therapist-guided (LITG) Internet-based program versus a completely self-guided (CSG) program.
• To evaluate these interventions against improved treatment as usual (iTAU) for depression.
• To assess outcomes in a primary health care setting in Spain.

Main Methods:

• A multicenter, three-arm, parallel randomized controlled trial (RCT) was conducted.
• 296 adults with mild to moderate depression were randomized to LITG, CSG, or iTAU.
• The "Smiling is Fun" Internet program (cognitive behavioral therapy-based) was used, with follow-up at 15 months.

Main Results:

• No significant differences were found between CSG, LITG, and iTAU at 3 months.
• Both CSG and LITG showed significant benefits compared to iTAU at 6 and 15 months.
• No significant differences were observed between the CSG and LITG groups at any time point.

Conclusions:

• Internet-based interventions for depression, when combined with iTAU, demonstrate a benefit over iTAU alone.
• These findings support the integration of digital mental health tools in primary care.
• The study highlights the potential of online CBT interventions for managing depression.