Online CBT Improves Depression Symptoms

JAMA Network Open

Amid a recent flurry of reports calling into question the effectiveness of virtual cognitive behavioral therapy, a new study published in JAMA Network Open found that computer-assisted CBT (CCBT) does in fact improve depressive symptoms in primary care patients.

  • Methodology – The study included 175 adult primary care patients at the University of Louisville who had scored 10 or higher on the Patient Health Questionnaire-9 (27 point scale), indicating at least a moderate case of clinical depression. Nearly 62% of participants made less than $30k/year, while 74% did not graduate from college.
  • Interventions – Participants were randomly assigned to CCBT or treatment-as-usual groups (TAU) for 12 weeks of active treatment, as well as 3- and 6-month follow ups. CCBT included 9 online CBT lessons and weekly 20-minute teletherapy visits, in addition to TAU, which included in-office treatment at the primary care practices. 
  • Results – CCBT led to significantly greater improvement in PHQ-9 scores than TAU (mean difference: -2.5), with the positive results maintained at 3-month (-2.3) and 6-month follow-ups (-3.2). CCBT remission rates were more than double TAU at all time points.

Conclusions and Relevance

This study was particularly interesting because of the treatment’s sustained results and because its participants largely came from groups that are often underrepresented in CCBT research. Although the study had some limitations (treatment-as-usual as a control can’t compare CCBT to regular CBT), the results suggest that CCBT has the potential to be particularly valuable for patients in diverse primary care settings.

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