Web-based, self-help intervention helps prevent depression

Among patients experiencing some symptoms of depression, the use of a web-based guided self-help intervention reduced the incidence of major depressive disorder over 12 months compared with enhanced usual care, according to a study appearing in the May 3 issue of JAMA.

Major depressive disorder (MDD) is a common condition associated with substantial illness and economic costs. It is projected that MDD will be the leading cause of premature mortality and disability in high-income countries by 2030. Evidence-based treatments for MDD are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD.

Claudia Buntrock, M.Sc., of Leuphana University Lueneburg, Germany, and colleagues randomly assigned 406 adults with subthreshold depression (some symptoms of depression, but no current MDD per certain criteria) to either a web-based guided self-help intervention (cognitive-behavioral and problem-solving therapy supported by an online trainer; n = 202) or a web-based psychoeducation program (n = 204). All participants had unrestricted access to usual care (visits to the primary care clinician).

Among the patients (average age, 45 years; 74 percent women), 335 (82 percent) completed the telephone follow-up at 12 months. The researchers found that 55 participants (27 percent) in the intervention group experienced MDD compared with 84 participants (41 percent) in the control group. The number needed to treat to avoid 1 new case of MDD was 6.

"Results of the study suggest that the intervention could effectively reduce the risk of MDD onset or at least delay onset," the authors write. "Further research is needed to understand whether the effects are generalizable to both first onset of depression and depression recurrence as well as efficacy without the use of an online trainer."