Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials

Reins JA, Buntrock C, Zimmermann J, Grund S, Harrer M, Lehr D, Baumeister H, Weisel K, Domhardt M, Imamura K, Kawakami N, Spek V, Nobis S, Snoek F, Cuijpers P, Klein JP, Moritz S, Ebert DD (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Psychotherapy and Psychosomatics Karger Publishers

DOI: 10.1159/000507819

Abstract

Introduction: Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. Objective: We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS), treatment response, close to symptom-free status, symptom deterioration and MDD onset as well as moderators of intervention outcomes. Methods: Randomized controlled trials were identified through systematic searches via PubMed, PsycINFO, Embase and Cochrane Library. Multilevel regression analyses were used to examine efficacy and moderators. Results: Seven trials (2,186 participants) were included. The IG was superior in DSS at all measurement points (posttreatment: 6-12 weeks; Hedges' g = 0.39 [95% CI: 0.25-0.53]; follow-up 1: 3-6 months; g = 0.30 [95% CI: 0.15-0.45]; follow-up 2: 12 months, g = 0.27 [95% CI: 0.07-0.47], compared with the CG. Significantly more participants in the IG than in the CG reached response and close to symptom-free status at all measurement points. A significant difference in symptom deterioration between the groups was found at the posttreatment assessment and follow-up 2. Incidence rates for MDD onset within 12 months were lower in the IG (19%) than in the CG (26%). Higher initial DSS and older age were identified as moderators of intervention effect on DSS. Conclusions: Our findings provide evidence for Internet-based interventions to be a suitable low-threshold intervention to treat individuals with sD and to reduce the incidence of MDD. This might be particularly true for older people with a substantial symptom burden.

Authors with CRIS profile

Claudia Buntrock Lehrstuhl für Klinische Psychologie und Psychotherapie Mathias Harrer Lehrstuhl für Klinische Psychologie und Psychotherapie Kiona Weisel Lehrstuhl für Klinische Psychologie und Psychotherapie

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Leuphana Universität Lüneburg DE Germany (DE) Universität Kassel DE Germany (DE) IPN - Leibniz-Institut für die Pädagogik der Naturwissenschaften und Mathematik DE Germany (DE) Universität Ulm DE Germany (DE) University of Tokyo JP Japan (JP) Fontys University of Applied Sciences NL Netherlands (NL) Amsterdam University Medical Centers (Amsterdam UMC) / Amsterdam Universitair Medische Centra NL Netherlands (NL) Vrije Universiteit Amsterdam (VU) / University Amsterdam NL Netherlands (NL) Universität zu Lübeck DE Germany (DE)

How to cite

APA:

Reins, J.A., Buntrock, C., Zimmermann, J., Grund, S., Harrer, M., Lehr, D.,... Ebert, D.D. (2020). Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials. Psychotherapy and Psychosomatics. https://doi.org/10.1159/000507819

MLA:

Reins, Jo Annika, et al. "Efficacy and Moderators of Internet-Based Interventions in Adults with Subthreshold Depression: An Individual Participant Data Meta-Analysis of Randomized Controlled Trials." Psychotherapy and Psychosomatics (2020).

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