Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression: a systematic review and component network meta-analysis using individual participant data

Autor: Louise Farrer, Kristofer Vernmark, Heleen Riper, Steffen Moritz, Florien W. Boele, Christine Knaevelsrud, Claudia Buntrock, Jesus Montero-Marin, Derek Richards, Alishia D. Williams, Thomas Berger, Annemieke van Straten, Andrea Cipriani, Lisa Sheeber, Marcus J.H. Huibers, Eirini Karyotaki, Robin Maria Francisca Kenter, Simon Gilbody, Anna C. M. Geraedts, Nadia Garnefski, Johan Lundgren, Jessica Smith, Heather D. Hadjistavropoulos, Marie Kivi, Jennifer Dahne, Sally Brabyn, Cecilia Björkelund, Jan Philipp Klein, Victor J M Pop, Ove Lintvedt, Lisanne Warmerdam, Isabelle M. Rosso, Kim M P van Bastelaar, Robert Johansson, Justine Schneider, Jason Shumake, Nicholas R. Forand, Wendy Theresia Maria Pots, Nicole E. Pugh, Scott L. Rauch, Orestis Efthimiou, Annet Kleiboer, Björn Meyer, Sanne van Luenen, Christopher G. Beevers, Manuel Heinrich, Lara Bücker, Johanna Schröder, Clara Miguel, Pavle Zagorscak, Viktor Kaldo, David Daniel Ebert, Jeannette Milgrom, Anna Carlotta Zarski, Rachel Phillips, Vivian Kraaij, Elizabeth Littlewood, Kathleen O’Moore, Toshi A. Furukawa, Viola Spek, Erik Forsell, Gerhard Andersson, Edoardo G Ostinelli, Pim Cuijpers, Iony D. Ezawa, Sarah Perini, Per Carlbring, Andrew Mackinnon, Daniel R. Strunk, Peter Johansson, Helen Christensen, Aya M Suganuma, Alan W. Gemmill, Isabella Choi, Jill M. Newby, David C. Mohr, Burçin Ünlü, Javier García-Campayo, Luke H. Schneider, Stephanie Nobis
Přispěvatelé: Medical psychology, Psychiatry, APH - Global Health, APH - Mental Health, Midwifery Science, Graduate School, Surgery, ACS - Atherosclerosis & ischemic syndromes
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Furukawa, T A, Suganuma, A, Ostinelli, E G, Andersson, G, Beevers, C G, Shumake, J, Berger, T, Boele, F W, Buntrock, C, Carlbring, P, Choi, I, Christensen, H, Mackinnon, A, Dahne, J, Huibers, M J H, Ebert, D D, Farrer, L, Forand, N R, Strunk, D R, Ezawa, I D, Forsell, E, Kaldo, V, Geraedts, A, Gilbody, S, Littlewood, E, Brabyn, S, Hadjistavropoulos, H D, Schneider, L H, Johansson, R, Kenter, R, Kivi, M, Björkelund, C, Kleiboer, A, Riper, H, Klein, J P, Schröder, J, Meyer, B, Moritz, S, Bücker, L, Lintvedt, O, Johansson, P, Lundgren, J, Milgrom, J, Gemmill, A W, Mohr, D C, Montero-Marin, J, Garcia-Campayo, J, Nobis, S, Zarski, A C, O'Moore, K, Williams, A D, Newby, J M, Perini, S, Phillips, R, Schneider, J, Pots, W, Pugh, N E, Richards, D, Rosso, I M, Rauch, S L, Sheeber, L B, Smith, J, Spek, V, Pop, V J, Ünlü, B, van Bastelaar, K M P, van Luenen, S, Garnefski, N, Kraaij, V, Vernmark, K, Warmerdam, L, van Straten, A, Zagorscak, P, Knaevelsrud, C, Heinrich, M, Miguel, C, Cipriani, A, Efthimiou, O, Karyotaki, E & Cuijpers, P 2021, ' Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression : a systematic review and component network meta-analysis using individual participant data ', The lancet. Psychiatry, vol. 8, no. 6, pp. 500-511 . https://doi.org/10.1016/S2215-0366(21)00077-8
The Lancet Psychiatry, 8(6), 500. Elsevier Limited
The lancet. Psychiatry, 8(6), 500-511. Elsevier Limited
Furukawa, T A, Suganuma, A, Ostinelli, E G, Andersson, G, Beevers, C G, Shumake, J, Berger, T, Boele, F W, Buntrock, C, Carlbring, P, Choi, I, Christensen, H, Mackinnon, A, Dahne, J, Huibers, M J H, Ebert, D D, Farrer, L, Forand, N R, Strunk, D R, Ezawa, I D, Forsell, E, Kaldo, V, Geraedts, A, Gilbody, S, Littlewood, E, Brabyn, S, Hadjistavropoulos, H D, Schneider, L H, Johansson, R, Kenter, R, Kivi, M, Bjorkelund, C, Kleiboer, A, Riper, H, Klein, J P, Schroder, J, Meyer, B, Moritz, S, Bucker, L, Lintvedt, O, Johansson, P, Lundgren, J, Milgrom, J, Gemmill, A W, Mohr, D C, Montero-Marin, J, Garcia-Campayo, J, Nobis, S, Zarski, A-C, O'Moore, K, Williams, A D, Newby, J M, Perini, S, Phillips, R, Schneider, J, Pots, W, Pugh, N E, Richards, D, Rosso, I M, Rauch, S L, Sheeber, L B, Smith, J, Spek, V, Pop, V J, Unlu, B, van Bastelaar, K M P, van Luenen, S, Garnefski, N, Kraaij, V, Vernmark, K, Warmerdam, L, van Straten, A, Zagorscak, P, Knaevelsrud, C, Heinrich, M, Miguel, C, Cipriani, A, Efthimiou, O, Karyotaki, E & Cuijpers, P 2021, ' Dismantling, optimising, and personalising internet cognitive behavioural therapy for depression : a systematic review and component network meta-analysis using individual participant data ', The Lancet. Psychiatry, vol. 8, no. 6, pp. 500-511 . https://doi.org/10.1016/S2215-0366(21)00077-8
The Lancet Psychiatry, 8(6), 500-511
Lancet Psychiatry
Lancet. Psychiatry, 8(6), 500-511. Elsevier Limited
ISSN: 2215-0366
2215-0374
Popis: BackgroundInternet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom.MethodsWe did a systematic review and individual participant data component network meta-analysis (cNMA) of iCBT trials for depression. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomised controlled trials (RCTs) published from database inception to Jan 1, 2019, that compared any form of iCBT against another or a control condition in the acute treatment of adults (aged ≥18 years) with depression. Studies with inpatients or patients with bipolar depression were excluded. We sought individual participant data from the original authors. When these data were unavailable, we used aggregate data. Two independent researchers identified the included components. The primary outcome was depression severity, expressed as incremental mean difference (iMD) in the Patient Health Questionnaire-9 (PHQ-9) scores when a component is added to a treatment. We developed a web app that estimates relative efficacies between any two combinations of components, given baseline patient characteristics. This study is registered in PROSPERO, CRD42018104683.FindingsWe identified 76 RCTs, including 48 trials contributing individual participant data (11 704 participants) and 28 trials with aggregate data (6474 participants). The participants' weighted mean age was 42·0 years and 12 406 (71%) of 17 521 reported were women. There was suggestive evidence that behavioural activation might be beneficial (iMD −1·83 [95% credible interval (CrI) −2·90 to −0·80]) and that relaxation might be harmful (1·20 [95% CrI 0·17 to 2·27]). Baseline severity emerged as the strongest prognostic factor for endpoint depression. Combining human and automated encouragement reduced dropouts from treatment (incremental odds ratio, 0·32 [95% CrI 0·13 to 0·93]). The risk of bias was low for the randomisation process, missing outcome data, or selection of reported results in most of the included studies, uncertain for deviation from intended interventions, and high for measurement of outcomes. There was moderate to high heterogeneity among the studies and their components.InterpretationThe individual patient data cNMA revealed potentially helpful, less helpful, or harmful components and delivery formats for iCBT packages. iCBT packages aiming to be effective and efficient might choose to include beneficial components and exclude ones that are potentially detrimental. Our web app can facilitate shared decision making by therapist and patient in choosing their preferred iCBT package.FundingJapan Society for the Promotion of Science.
Databáze: OpenAIRE
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