A computer-assisted depression intervention in primary care

Psychol Med. 2011 Jul;41(7):1373-83. doi: 10.1017/S0033291710001935. Epub 2010 Oct 20.

Abstract

Background: The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial.

Method: A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention.

Results: Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants.

Conclusions: The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact, ≤ 5 min from a psychologist 2 weeks after receiving the program). Overall, the findings add support to the accumulating evidence for the potential clinical benefit of computer-assisted behavioral health interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • Primary Health Care / methods*
  • Referral and Consultation
  • Surveys and Questionnaires
  • Therapy, Computer-Assisted / methods*
  • Treatment Outcome
  • Young Adult