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Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial

Citation

Titov, N and Dear, BF and Johnston, L and McEvoy, PM and Wootton, B and Terides, MD and Gandy, M and Fogliati, V and Kayrouz, R and Rapee, RM, Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12-month follow-up of a randomised controlled trial, PLOS ONE, 9, (2) pp. 8. ISSN 1932-6203 (2014) [Refereed Article]


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Copyright Statement

Copyright 2014 Titov et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: doi:10.1371/journal.pone.0089591

Abstract

Background: A recent paper reported the outcomes of a study examining a new self-guided internet-delivered treatment, the Wellbeing Course, for symptoms of anxiety or depression. This study found the intervention resulted in significant symptom reductions. It also found that automated emails increased treatment completion and clinical improvements in a subsample with elevated anxiety and depression.

Aims: To examine the clinical outcomes and the effect of automated emails at 12 months post-treatment.

Method: Participants, who were randomly allocated to a Treatment Plus Automated Emails Group (TEG; n = 100), a standard Treatment Group (TG; n = 106) or delayed-treatment Waitlist Control Group (Control; n = 51), were followed up at 12 months post-treatment. Eighty-one percent, 78% and 87% of participants in the TEG, TG and treated Waitlist Control Group provided symptom data at 12-month follow-up, respectively. The primary outcome measures were the Patient Health Questionnaire-9 Item Scale (PHQ-9) and the Generalized Anxiety Disorder-7 Item Scale (GAD-7).

Results: Significant improvements in symptoms of anxiety and depression were observed over time in both the TEG and TG (Fs >69, ps <.001) these were sustained from post-treatment to 12-month follow-up (ps >.05), and were associated with large effect sizes. No statistically significant differences in symptoms were found between the TEG and TG at post-treatment, 3-month or 12-month follow-up. Previously reported symptom differences between TEG and TG participants with comorbid symptoms were no longer present at 12-month follow-up (ps >.70).

Conclusions: The overall benefits of the Wellbeing Course were sustained at 12-month follow-up. Although automated emails facilitated Course completion and reductions in symptoms for participants with comorbid anxiety and depression from pre-post treatment, these differences were no longer observed at 12-month follow-up. The results indicate that automated emails promote more rapid treatment response for people with elevated and comorbid symptoms, but may not improve longer term outcomes.

Item Details

Item Type:Refereed Article
Keywords:internet, treatment, anxiety, depression
Research Division:Psychology and Cognitive Sciences
Research Group:Psychology
Research Field:Health, Clinical and Counselling Psychology
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Mental Health
Author:Wootton, B (Dr Bethany Wootton)
ID Code:90820
Year Published:2014
Web of Science® Times Cited:17
Deposited By:Psychology
Deposited On:2014-04-25
Last Modified:2014-08-08
Downloads:159 View Download Statistics

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