Internet-Delivered Cognitive Behavioural Therapy for Adults with Mild to Moderate Depression and High Cardiovascular Disease Risks: A Randomised Attention-Controlled Trial
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Key result
Internet-delivered Cognitive Behaviour Therapy reduced depressive symptoms by 1.06 points more than an attention control in adults with mild to moderate depression and high cardiovascular risks.
Why the study?
Does internet-delivered Cognitive Behaviour Therapy (iCBT) reduce depressive symptom severity in adults with mild to moderate depression and high cardiovascular disease risks?
Population
562 adults with mild to moderate depression and high cardiovascular disease risks or self-reported history…
Comparison
Internet-delivered Cognitive Behaviour Therapy… vs Internet-delivered attention control health…
Design
RCT, Customised, fully automated randomisation facility, stratified by…
Follow-up
12 weeks
Authors
Discussion
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Member takes
Implication
Supports iCBT for mild-moderate depression in high-CVD-risk adults; extends CBT evidence to scalable internet delivery.
Study Design
Type
RCT (n=562)
Blinding
Double-blind
Randomization
Permuted block
Multicenter
No
Structured PICO
Does internet-delivered Cognitive Behaviour Therapy (iCBT) reduce depressive symptom severity in adults with mild to moderate depression and high cardiovascular disease risks?
P
Population
562 adults with mild to moderate depression (PHQ-9 score ≥8) and high cardiovascular disease (CVD) risks or self-reported history of CVD, mean age ~58, ~61% female, based in New South Wales, Australia. Key inclusion: self-reported history of CVD or risk factors, psychological distress (K-10 ≥16), and PHQ-9 score ≥8.
I
Intervention
Internet-delivered Cognitive Behaviour Therapy (iCBT) programme (E-couch) comprising 12 modules of psychoeducation, CBT, and interpersonal psychotherapy techniques delivered sequentially weekly over 12 weeks.
C
Comparator
Internet-delivered attention control health information package (HealthWatch) comprising a 12-week online programme delivering health information on topics including nutrition, stroke, physical activity, and heart health.
O
Outcome
Depression symptom severity from baseline to post intervention (12 weeks) measured using the nine-item Patient Health Questionnaire (PHQ-9).patient reported
Main Result
Effect estimate: Mean difference 1.06 (95% CI 0.23-1.89)
Absolute Event Rate: 3.66% vs 2.6%
p-value: p=0.012
In adults with mild to moderate depression and high CVD risk, a 12-week internet-delivered CBT program produced a small but significant improvement in depressive symptoms and adherence to medical and lifestyle advice compared to an attention control.
Limitations
- Inclusion definitions were based entirely upon self-report, which could have led to misclassification.
- Lower post-test completion rate in the intervention arm (76%) compared to the control arm (97%).
- Reliance upon self-report for adherence measures, which may reflect a reporting bias.
- Inclusion definitions based entirely upon self report which could lead to misclassification
- Moderately differential end point completion rate with lower post-test completion in the intervention arm (76% vs 97% in control)
Cite This Study
Glozier et al. (2013) conducted an RCT in Mild to moderate depression and high cardiovascular disease risks (n=562). Internet-delivered Cognitive Behaviour Therapy (iCBT) / E-couch vs. Internet-delivered attention control health information package (HealthWatch) was evaluated on Change in depression symptom severity (PHQ-9 score) from baseline to 12 weeks (Mean difference 1.06, 95% CI 0.23-1.89, p=0.012). Internet-delivered Cognitive Behaviour Therapy reduced depressive symptoms by 1.06 points more than an attention control in adults with mild to moderate depression and high cardiovascular risks.
Topics
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