Delivering CBT for depression via the Internet. Predicting outcome at 6-months follow-up

Background
Mild to moderate depression has been successfully treated with cognitive-behavioural (CBT) bibliotherapy, including minimal therapist contact. More recently, Internet has been used to deliver the treatment, with obvious gains in terms of cost reduction and increased accessibility. In the present study we analyzed pre-treatment predictors of improvement following Internet based self-help treatment of depression.

Patients and method
Included were 71 participants from a randomized trial who completed a 6-month follow-up. A combined change score index was calculated from the Beck Depression Inventory and the Montgomery Åsberg Depression Rating Scale.


Results
Pre-treatment levels of depression were related to outcome, with higher scores on the BDI and the MADRS being associated with more improvement. On the other hand, and in line with the depression literature, number of previous depression episodes was negatively associated with outcome.

Discussion
In common with traditional psychotherapy studies, finding predictors of outcome is a difficult task. Patients with repeated episodes of depression might benefit less from self-help over the Internet, but as the correlation is weak no firm conclusions can be drawn. Key words: Internet, prediction of treatment, depression, self-help