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      A Comparison of Changes in Anxiety and Depression Symptoms of Spontaneous Users and Trial Participants of a Cognitive Behavior Therapy Website

      research-article
      , PhD 1 , , , PhD 1 , , BSc 1 , , BA(Hons) 1 , , BA(Hons) 1
      (Reviewer)
      Journal of Medical Internet Research
      Gunther Eysenbach
      Internet, mental health, depression

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          Abstract

          Background

          In randomized controlled trials Internet sites have been shown to be effective in the treatment of depression and anxiety. However, it is unclear if the positive effects demonstrated in these trials transfer to community users of such sites.

          Objective

          To compare anxiety and depression outcomes for spontaneous visitors to a publicly accessible cognitive behavior therapy website (MoodGYM) (http://moodgym.anu.edu.au) with outcomes achieved through a randomized controlled efficacy trial of the same site.

          Methods

          All community visitors to the MoodGYM site between April 2001 and September 2003 were sampled: 182 participants in the BlueMood Trial who had been randomly assigned to the MoodGYM site as part of a large trial and 19607 visitors (public registrants) to the site. Symptom assessments (quizzes) were repeated within the website intervention to allow the examination of change in symptoms across modules. Outcome variables were (1) age, gender, initial depression severity scores, and number of assessments attempted, and (2) symptom change measures based on Goldberg anxiety and depression scores recorded on a least two occasions.

          Results

          Public registrants did not differ from trial participants in gender, age, or initial level of depression, which was high for both groups relative to previously published epidemiological data sets. Trial participants completed more assessments. No significant differences in anxiety or depression change scores were observed, with both public registrants and trial participants improving through the training program.

          Conclusions

          Public registrants to a cognitive behavior therapy website show significant change in anxiety and depression symptoms. The extent of change does not differ from that exhibited by participants enrolled on the website for a randomized controlled trial.

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          Most cited references17

          • Record: found
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          • Article: not found

          Delivering interventions for depression by using the internet: randomised controlled trial.

          To evaluate the efficacy of two internet interventions for community-dwelling individuals with symptoms of depression--a psychoeducation website offering information about depression and an interactive website offering cognitive behaviour therapy. Randomised controlled trial. Internet users in the community, in Canberra, Australia. 525 individuals with increased depressive symptoms recruited by survey and randomly allocated to a website offering information about depression (n = 166) or a cognitive behaviour therapy website (n = 182), or a control intervention using an attention placebo (n = 178). Change in depression, dysfunctional thoughts; knowledge of medical, psychological, and lifestyle treatments; and knowledge of cognitive behaviour therapy. Intention to treat analyses indicated that information about depression and interventions that used cognitive behaviour therapy and were delivered via the internet were more effective than a credible control intervention in reducing symptoms of depression in a community sample. For the intervention that delivered cognitive behaviour therapy the reduction in score on the depression scale of the Center for Epidemiologic Studies was 3.2 (95% confidence interval 0.9 to 5.4). For the "depression literacy" site (BluePages), the reduction was 3.0 (95% confidence interval 0.6 to 5.2). Cognitive behaviour therapy (MoodGYM) reduced dysfunctional thinking and increased knowledge of cognitive behaviour therapy. Depression literacy (BluePages) significantly improved participants' understanding of effective evidence based treatments for depression (P < 0.05). Both cognitive behaviour therapy and psychoeducation delivered via the internet are effective in reducing symptoms of depression.
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            • Article: not found

            Interpreting scores on the Kessler Psychological Distress Scale (K10).

            To provide normative data on the Kessler Psychological Distress Scale (K10), a scale that is being increasingly used for clinical and epidemiological purposes. The National Survey of Mental Health And Well-Being was used to provide normative comparative data on symptoms, disability, service utilisation and diagnosis for the range of possible K10 scores. The K10 is related in predictable ways to these other measures. The K10 is suitable to assess morbidity in the population, and may be appropriate for use in clinical practice.
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              • Abstract: found
              • Article: not found

              Detecting anxiety and depression in general medical settings.

              To aid general practitioners and other non-psychiatrists in the better recognition of mental illness short scales measuring anxiety and depression were derived by latent trait analysis from a standardised psychiatric research interview. Designed to be used by non-psychiatrists, they provide dimensional measures of the severity of each disorder. The full set of nine questions need to be administered only if there are positive answers to the first four. When assessed against the full set of 60 questions contained in the psychiatric assessment schedule they had a specificity of 91% and a sensitivity of 86%. The scales would be used by non-psychiatrists in clinical investigations and possibly also by medical students to familiarise them with the common forms of psychiatric illness, which are often unrecognised in general medical settings.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                Gunther Eysenbach (Centre for Global eHealth Innovation, Toronto, Canada )
                1438-8871
                Oct-Dec 2004
                22 December 2004
                : 6
                : 4
                : e46
                Affiliations
                [1] 1simpleThe Centre for Mental Health Research simpleThe Australian National University CanberraAustralia
                Article
                v6i4e46
                10.2196/jmir.6.4.e46
                1550629
                15631970
                79409306-d7a6-40d8-b182-ce5cf1d4f4fb
                © Helen Christensen, Kathleen M Griffiths, Ailsa E Korten, Kylie Brittliffe, Chloe Groves. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.12.2004. Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, including full bibliographic details and the URL (see "please cite as" above), and this statement is included.
                History
                : 4 September 2004
                : 27 September 2004
                : 27 October 2004
                : 8 November 2004
                Categories
                Original Paper

                Medicine
                internet,mental health,depression
                Medicine
                internet, mental health, depression

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