The effectiveness of blended cognitive behaviour therapy in the treatment of depression.

Background

Major depression disorder is common and results in enormous suffering and economic costs. The efficacy of blended cognitive behaviour therapy in the treatment of depression has been shown in several controlled trials. However, there’s still much to be discovered about the usage of these combined face-to-face and online treatments and which factors influence their effectiveness. The objective of this study was to examine the use and longitudinal effectiveness of an uncontrolled blended (face-to-face treatment combined with a six-session web-based treatment) cognitive behavioural treatment (CBT) for major depression disorder.

 

Method

Cumulative anonymous logfile data were analyzed from over 2000 users who registered for the Therapieland depression CBT program from May 2018 and May 2019. These participants enrolled in a six-session web-based depression CBT program, which they followed on top of a face-to-face treatment. 

 

The following criteria were included when trimming the data set:

 

  • Participants who did not complete pre- and post-measurement of the QIDS questionnaire were excluded;
  • Participants with a total baseline score of less than 6 on the QIDS-SR, indicating normal / no depressive symptoms (Rush et al., 2003) were excluded;
  • Between the pre- and post-measurement on the QIDS-SR there was a minimum of 14 and a maximum of 140 days. If the difference in time between the total scores is less than 2 and longer than 20 weeks, data from this participant was excluded.

 

Linear mixed-model (LMM) repeated measures analysis was performed to compare the primary scores (the total scores on the QIDS-SR) over time at t (1) and t (2).

 

Results

The final sample consisted of 220 participants (134 women and 86 men) with an average age of 39 years (SD 13.62). Across the total group, the severity of depressive complaints decreased significantly over time between the pre- and post-measurement (F (1, 219) = 170.52, p <.001). This decline translates to a decrease in the severity of depression symptoms from moderate to mild. We found no evidence for a predictive value on the effect for the following determinants: sex, age, days between both measurements, adherence to the online program, the number of logins, the amount of homework made between both measurements, and depression severity.

 

Conclusion

This study shows that participants who enroll in the Therapieland depression CBT program as part of a blended treatment show a clear downward trend on depressive symptoms. It suggests that this trend holds for both women and men, for different ages, and for patients with varying degrees of depression severity. These results would suggest a positive implication for this type of treatment, as this would mean that the treatment would be effective for a broad range of patients suffering from depression.

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