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Eirini Karyotaki, Orestis Efthimiou, Clara Miguel, Frederic Maas genannt Bermpohl, Toshi A. Furukawa, Pim J. Cuijpers, Heleen M. Riper, Vikram Patel, Adriana Mira, Alan W. Gemmill and 63 more
Importance: Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective: To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depression using patient-level information. Data Sources: We searched PubMed, Embase, PsycInfo, and Cochrane Library to identify randomized clinical trials (RCTs) published up to January 1, 2019. Study Selection: Eligible RCTs were those comparing guided or unguided iCBT against each other or against any control intervention in individuals with depression. Available individual patient data (IPD) was collected from all eligible studies. Depression symptom severity was assessed after treatment, 6 months, and 12 months after randomization. Data Extraction and Synthesis: We conducted a systematic review and IPD network meta-analysis and estimated relative treatment effect sizes across different patient characteristics through IPD network meta-regression. Main Outcomes and Measures: Patient Health Questionnaire-9 (PHQ-9) scores. Results: Of 42 eligible RCTs, 39 studies comprising 9751 participants with depression contributed IPD to the IPD network meta-analysis, of which 8107 IPD were synthesized. Overall, both guided and unguided iCBT were associated with more effectiveness as measured by PHQ-9 scores than control treatments over the short term and the long term. Guided iCBT was associated with more effectiveness than unguided iCBT (mean difference [MD] in posttreatment PHQ-9 scores, -0.8; 95% CI, -1.4 to -0.2), but we found no evidence of a difference at 6 or 12 months following randomization. Baseline depression was found to be the most important modifier of the relative association for efficacy of guided vs unguided iCBT. Differences between unguided and guided iCBT in people with baseline symptoms of subthreshold depression (PHQ-9 scores 5-9) were small, while guided iCBT was associated with overall better outcomes in patients with baseline PHQ-9 greater than 9. Conclusions and Relevance: In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression, benefits were more substantial in individuals with moderate to severe depression. Unguided iCBT was associated with similar effectiveness among individuals with symptoms of mild/subthreshold depression. Personalized treatment selection is entirely possible and necessary to ensure the best allocation of treatment resources for depression.
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Karyotaki, E., Efthimiou, O., Miguel, C., Bermpohl, F. M. G., Furukawa, T. A., Cuijpers, P. J., Riper, H. M., Patel, V., Mira, A., Gemmill, A. W., Yeung, A., Lange, A., Williams, A. D., Mackinnon, A. J., Geraedts, A. S., Straten, A. V., Meyer, B., Björkelund, C., Knaevelsrud, C., … Forsell, Y. (2021). Internet-Based Cognitive Behavioral Therapy for Depression. JAMA Psychiatry, 78(4), 361. https://doi.org/10.1001/jamapsychiatry.2020.4364
Karyotaki, Eirini, et al. "Internet-Based Cognitive Behavioral Therapy for Depression." JAMA Psychiatry, vol. 78, no. 4, 2021, pp. 361, https://doi.org/10.1001/jamapsychiatry.2020.4364.
Karyotaki, Eirini, Orestis Efthimiou, Clara Miguel, Frederic Maas genannt Bermpohl, Toshi A. Furukawa, Pim J. Cuijpers, Heleen M. Riper, et al. "Internet-Based Cognitive Behavioral Therapy for Depression." JAMA Psychiatry 78, no. 4 (2021): 361. https://doi.org/10.1001/jamapsychiatry.2020.4364.
Karyotaki E., Efthimiou O., Miguel C. [и др.] Internet-Based Cognitive Behavioral Therapy for Depression // JAMA Psychiatry. — 2021. — Vol. 78, № 4. — P. 361. — URL: https://doi.org/10.1001/jamapsychiatry.2020.4364
@article{karyotaki2021internetbased,
title = {{Internet-Based Cognitive Behavioral Therapy for Depression}},
author = {Eirini Karyotaki and Orestis Efthimiou and Clara Miguel and Frederic Maas genannt Bermpohl and Toshi A. Furukawa and Pim J. Cuijpers and Heleen M. Riper and Vikram Patel and Adriana Mira and Alan W. Gemmill and Albert Yeung and Alfred Lange and Alishia D. Williams and Andrew James Mackinnon and Anna S. Geraedts and Annemieke van Straten and Björn Meyer and Cecilia Björkelund and Christine Knaevelsrud and Christopher Graham Beevers and Cristina Botella and Daniel R. Strunk and David C. Mohr and David Daniel Ebert and David S. Kessler and Derek Richards and Elizabeth Littlewood and Erik Forsell and Fan Feng and Fang Wang and Gerhard Andersson and Heather D. Hadjistavropoulos and Heleen Christensen and Iony D. Ezawa and Isabella Choi and Isabelle M. Rosso and Jan Philipp Klein and Jason Shumake and Javier García‐Campayo and Jeannette Milgrom and Jessica Simons Smith and Jesús Montero‐Marín and Jill Maree Newby and Juana María Bretón-López and Justine M. Schneider and Kristofer Vernmark and Lara Bücker and Lisa Sheeber and Lisanne Warmerdam and Louise M. Farrer and Manuel Heinrich and Marcus J. H. Huibers and Marie Kivi and Martin Kraepelien and Nicholas R. Forand and Nicky Pugh and Nils Lindefors and Ove Lintvedt and Pavle Zagorscak and Per Carlbring and Rachel Phillips and Robert Johansson and Ronald C. Kessler and Sally Brabyn and Sarah J. Perini and Scott L. Rauch and Simon M. Gilbody and Steffen Moritz and Thomas Berger and Victor J. Pop and Viktor Kaldo and Viola Spek and Yvonne Forsell},
journal = {JAMA Psychiatry},
year = {2021},
volume = {78},
number = {4},
pages = {361},
doi = {10.1001/jamapsychiatry.2020.4364},
url = {https://doi.org/10.1001/jamapsychiatry.2020.4364}
}TY - JOUR AU - Karyotaki, Eirini AU - Efthimiou, Orestis AU - Miguel, Clara AU - Bermpohl, Frederic Maas genannt AU - Furukawa, Toshi A. AU - Cuijpers, Pim J. AU - Riper, Heleen M. AU - Patel, Vikram AU - Mira, Adriana AU - Gemmill, Alan W. AU - Yeung, Albert AU - Lange, Alfred AU - Williams, Alishia D. AU - Mackinnon, Andrew James AU - Geraedts, Anna S. AU - Straten, Annemieke van AU - Meyer, Björn AU - Björkelund, Cecilia AU - Knaevelsrud, Christine AU - Beevers, Christopher Graham AU - Botella, Cristina AU - Strunk, Daniel R. AU - Mohr, David C. AU - Ebert, David Daniel AU - Kessler, David S. AU - Richards, Derek AU - Littlewood, Elizabeth AU - Forsell, Erik AU - Feng, Fan AU - Wang, Fang AU - Andersson, Gerhard AU - Hadjistavropoulos, Heather D. AU - Christensen, Heleen AU - Ezawa, Iony D. AU - Choi, Isabella AU - Rosso, Isabelle M. AU - Klein, Jan Philipp AU - Shumake, Jason AU - García‐Campayo, Javier AU - Milgrom, Jeannette AU - Smith, Jessica Simons AU - Montero‐Marín, Jesús AU - Newby, Jill Maree AU - Bretón-López, Juana María AU - Schneider, Justine M. AU - Vernmark, Kristofer AU - Bücker, Lara AU - Sheeber, Lisa AU - Warmerdam, Lisanne AU - Farrer, Louise M. AU - Heinrich, Manuel AU - Huibers, Marcus J. H. AU - Kivi, Marie AU - Kraepelien, Martin AU - Forand, Nicholas R. AU - Pugh, Nicky AU - Lindefors, Nils AU - Lintvedt, Ove AU - Zagorscak, Pavle AU - Carlbring, Per AU - Phillips, Rachel AU - Johansson, Robert AU - Kessler, Ronald C. AU - Brabyn, Sally AU - Perini, Sarah J. AU - Rauch, Scott L. AU - Gilbody, Simon M. AU - Moritz, Steffen AU - Berger, Thomas AU - Pop, Victor J. AU - Kaldo, Viktor AU - Spek, Viola AU - Forsell, Yvonne TI - Internet-Based Cognitive Behavioral Therapy for Depression JO - JAMA Psychiatry VL - 78 IS - 4 SP - 361 PY - 2021 DA - 2021/01/20 DO - 10.1001/jamapsychiatry.2020.4364 UR - https://doi.org/10.1001/jamapsychiatry.2020.4364 ER -
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