Introduction: Psychotherapy is a first-line treatment for depression. However, capacities are limited, leading to long waiting times for outpatient psychotherapy in health care systems. Web-based interventions (WBI) could help to bridge this treatment gap. Objective: This study investigates the effectiveness of a guided cognitive-behavioral WBI in depressive patients seeking face-to-face psychotherapy. Methods: A 2-arm randomized controlled trial was conducted. Depressive patients (n = 136) recruited from the waiting lists of outpatient clinics were randomly assigned to an intervention group (IG; treatment as usual [TAU] + immediate access to WBI) or a control group (CG; TAU + access to WBI after follow-up). Depressive symptoms and secondary outcomes were assessed at baseline, 7 weeks, and 5 months after randomization. Results: Mixed-model analyses revealed a significant group × time interaction effect on depressive symptoms (F_{2, 121.5} = 3.91; p #x3c; 0.05). Between-group effect sizes were d = 0.55 at 7 weeks and d = 0.52 at 5 months. The IG was superior regarding psychological symptoms and mental health quality of life but not on physical health quality of life, attitudes, motivation for psychotherapy, or subjective need and uptake of psychotherapy. Conclusions: Patients waiting for face-to-face psychotherapy can benefit from a WBI when compared to TAU. Despite the reduction of depressive symptoms in the IG, the uptake of subsequent psychotherapy was still high in both groups. The effects remained stable at the 5-month follow-up. However, this study could not determine the proportion of specific intervention effects vs. nonspecific effects, such as positive outcome expectations or attention. Future research should focus on the long-term effects and cost-effectiveness of WBI before psychotherapy.
Psychother Psychosom

中文翻译：

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门诊心理治疗前基于网络的指导干预减少抑郁症状的有效性：一项务实的随机对照试验

简介：心理治疗是抑郁症的一线治疗方法。然而，能力有限，导致卫生保健系统中门诊心理治疗的等待时间很长。基于网络的干预 (WBI) 可以帮助弥合这一治疗差距。目的：本研究调查了指导性认知行为 WBI 在寻求面对面心理治疗的抑郁症患者中的有效性。方法：进行了一项 2 臂随机对照试验。抑郁症患者 ( n= 136) 从门诊候诊名单中招募，随机分配到干预组（IG；照常治疗 [TAU] + 立即访问 WBI）或对照组（CG；TAU + 随访后访问 WBI） . 在基线、随机化后 7 周和 5 个月时评估抑郁症状和次要结局。结果：混合模型分析揭示了显着的组×时间交互作用对抑郁症状的影响 ( F _{2, 121.5} = 3.91; p #x3c; 0.05)。7 周时的组间效应大小为d = 0.55，d= 5 个月时的 0.52。IG 在心理症状和心理健康生活质量方面具有优势，但在生理健康生活质量、态度、心理治疗动机或心理治疗的主观需要和接受方面没有优势。结论：与 TAU 相比，等待面对面心理治疗的患者可以从 WBI 中受益。尽管 IG 中的抑郁症状有所减轻，但后续心理治疗的接受率在两组中仍然很高。在 5 个月的随访中，效果保持稳定。然而，这项研究无法确定特定干预效果与非特定效果的比例，例如积极的结果预期或注意力。未来的研究应侧重于心理治疗前 WBI 的长期效果和成本效益。
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