Computer assisted CBT provides little or no benefits for depression

November 11, 2015

Researchers at the University of York have revealed computerised cognitive behavioural therapy (cCBT) is likely to be ineffective in the treatment of depression.

Published in the British Medical Journal (BMJ), Professor Simon Gilbody from York's Department of Health Sciences and the Hull York Medical School led the REEACT trial. The study was funded by the National Institute of Health Research Health Technology Programme.

Cognitive behavioural therapy (CBT) delivered by a trained therapist is considered to be a highly effective "talking treatment" for depression, but this is not always immediately available through the NHS. One alternative is the delivery of CBT via specially-designed computer programmes which can be used to increase access.

To judge the effectiveness of computerised CBT, York researchers carried out the largest randomised control trial to date, assessing the effectiveness of cCBT when added to usual GP care.

The REEACT trial included 691 patients with depression carefully selected from 83 general practices across England.

Results showed that cCBT offered little or no benefit over usual GP care.

Patients generally did not engage with computer programmes on a sustained basis, and they highlighted the difficulties of repeatedly logging on to computer systems when clinically depressed.

Dr Elizabeth Littlewood, who managed the REEACT trial, said: "Current NICE guidelines recommend the use of cCBT as a treatment for depression, but there was a need to carry out a large trial to judge the value of these treatments as they are offered in the NHS. Our findings show that cCBT is likely to be an ineffective form of low-intensity treatment for depression and an inefficient use of finite healthcare resources.

"Despite the high level of technical support and weekly encouragement to use the computer packages, there was general low adherence and engagement with this form of treatment. It seems that participants often want more clinical support in addition to therapy."

Professor Gilbody, Director of the York Mental Health and Addictions Research Group (MHARG) and Chief Investigator of the REEACT study, added: "These findings have important implications for those who commission services and purchase commercial products on behalf of publicly funded health services. Depression is a treatable condition and there a number of effective interventions that can be offered. We know that CBT works very well for depression but this research make us less sure that it can be treated when computers alone are used to deliver this treatment."

Professor Karl Atkin, Head of Department at Health Sciences in York, concluded: "This is one of a number of large scale trials in this area to be conducted by MHARG and the York Trials Unit. Such research is essential in ensuring the best care is offered in the NHS and finite healthcare resources are used to the maximum benefit for patients. This is the type of research which York does very well."
-end-


University of York

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.