Internet-delivered disease management for recurrent depression: a multicenter randomized controlled trial
<b><i>Background:</i></b> Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals. <b><i>...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 26, 2016
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| In: |
Psychotherapy and psychosomatics
Year: 2016, Volume: 85, Issue: 2, Pages: 91-98 |
| ISSN: | 1423-0348 |
| DOI: | 10.1159/000441951 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000441951 Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/441951 
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| Author Notes: | Hans Kordy, Markus Wolf, Kai Aulich, Martin Bürgy, Ulrich Hegerl, Johannes Hüsing, Bernd Puschner, Christine Rummel-Kluge, Helmut Vedder, Matthias Backenstrass |
| Summary: | <b><i>Background:</i></b> Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals. <b><i>Methods:</i></b> Efficacy was tested in a 3-arm, multicenter, open-label, evaluator-blind, randomized controlled trial. Upon discharge from inpatient mental health care, 232 adults with 3 or more major depressive episodes were randomized to 1 of 2 intervention groups (SUMMIT or SUMMIT-PERSON) or to treatment as usual (TAU) alone. Over 12 months, participants in both intervention arms received, in addition to TAU, intense monitoring via e-mail or a smartphone, including signaling of upcoming crises, assistance with personal crisis management, and facilitation of early intervention. SUMMIT-PERSON additionally offered regular expert chats. The primary outcome was ‘well weeks', i.e. weeks with at most mild symptoms assessed by the Longitudinal Interval Follow-Up Evaluation, during 24 months after the index treatment. <b><i>Results:</i></b> SUMMIT compared to TAU reduced the time with an unwell status (OR 0.48; 95% CI 0.23-0.98) through faster transitions from unwell to well (OR 1.44; 95% CI 0.83-2.50) and slower transitions from well to unwell (OR 0.69; 95% CI 0.44-1.09). Contrary to the hypothesis, SUMMIT-PERSON was not superior to either SUMMIT (OR 0.77; 95% CI 0.38-1.56) or TAU (OR 0.62; 95% CI 0.31-1.24). The efficacy of SUMMIT was strongest 8 months after the intervention. <b><i>Conclusions:</i></b> The fully automated Internet-delivered augmentation strategy SUMMIT has the potential to improve TAU by reducing the lifelong burden of patients with recurrent depression. The fact that the effects wear off suggests a time-unlimited extension. |
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| Item Description: | Gesehen am 15.05.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1423-0348 |
| DOI: | 10.1159/000441951 |