Magazine article Clinical Psychiatry News

Online CBT Helps Some with Depression, GAD

Magazine article Clinical Psychiatry News

Online CBT Helps Some with Depression, GAD

Article excerpt


Internet-based cognitive-behavioral therapy is a treatment approach that can benefit patients with anxiety and depression, researchers report.

The study, conducted by Matthew Sunderland, Ph.D., and colleagues, bolsters the case for the web-based approach as a way of overcoming treatment obstacles such as the lack of rural-based services and wait time (Behavior Res. Ther. 2012;50:374-80).

Dr. Sunderland and his colleagues have been engaged in creating a web-based option for general practitioners and other front-line workers to treat patients, freeing therapy time for those patients in need of more intensive treatment. Hindering this goal has been a lack of information on the "trajectory of change" of patients during the treatment course, reported Dr. Sunderland of the University of New South Wales, Sydney.

The investigators studied 663 patients who completed an online cognitive-behavioral therapy (CBT) course for depression (n=302; 58% female) and genera1ized anxiety disorder (GAD) (n=361; 74% female). The patients' average age was 43. The primary outcome measure was the Kessler-10 psychological distress scale. The time course of depression and GAD was respectively determined using the Patient Health Questionnaire-9 and GAD-7 instruments. Levels of functional impairment over the previous 30 days were measured using the World Health Organization Disability Assessment Schedule 2.0. Most (75%-80%) patients with either psychological disorder displayed progressive and clinically significant improvements over the period of the six online course lessons, corroborating previous studies.

But the rest were "low responders," whose initial improvement leveled off and even slightly regressed in the later sessions, indicating to the researchers that Internet CBT for anxiety and depression "may be better suited as an initial step within a stepped care model for treatment. …

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