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Treatment of Depression in Primary Care with Computerized Psychological Therapies: Systematic Reviews

  • Systems-Level Quality Improvement
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Abstract

Depression is one of the most important causes of disability due to illness in our environment. The primary care health system receives a high percentage of this consultation about psychological distress. Often this end in a pharmacological overtreatment in patients with mild depression, due to a lack of access to alternative tools for management. To analyze the evidence that exists by now about the effectiveness of computerized psychological therapies, in people with depression in primary care setting. The search process was mainly done through MEDLINE and Cochrane using keywords such as: “depression”, “treatment”, “primary care”, “online”, “internet”, “computerized”, “Cognitive Behavioral Therapy” and delimiting the search by years and types of studies. The Oxman quality scale was used to analyze quality of Systematic Reviews (SR). 11 previous SR were analyzed. Almost all research is experimental and has not been implemented in the public health network except in the United Kingdom, where there is a tradition in the use of the Beating the Blues program. It requires research in our country and development of programs in Spanish, or adaptation of those of other countries, to test the effectiveness in our health system and to study, in turn, the cost-efficiency. But it is proven to be effective in reducing depressive symptoms and must be study as a possible tool to be introduced in the management of depression in non-specialized care.

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References

  1. World Health Organization. Centro de Prensa: Depresión, nota descriptiva n°369. In: WHO [Internet]. World Health Organization; 2017 [cited 7 Jun 2015]. Available: http://www.who.int/mediacentre/factsheets/fs369/es/

  2. Mathers C. D, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. Samet J, editor. PLoS Med. Public Library of Science; 2006;3: e442. https://doi.org/10.1371/journal.pmed.0030442, 11

    Article  Google Scholar 

  3. Haro, J., Palacín, C., Vilagut, G., Bernal, M., Luque, I., Codony, M. et al., Prevalencia de los trastornos mentales y factores asociados: resultados del estudio ESEMeD-España. Med Clin (Barc) 126:445–451, 2006 Available: https://medes.com/publication/21303.

    Article  Google Scholar 

  4. Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H. et al., Prevalence of mental disorders in Europe: Results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand. 109:21–27, 2004. https://doi.org/10.1111/j.1600-0047.2004.00327.x.

    Article  Google Scholar 

  5. Vindel A. C, Salguero J. M, Wood C. M, Dongil E, Latorre JM. LA DEPRESIÓN EN ATENCIÓN PRIMARIA: PREVALENCIA, DIAGNÓSTICO Y TRATAMIENTO. Papeles del Psicólogo. Consejo General de Colegios Oficiales de Psicólogos; 2012;33: 2–11. Available: http://www.redalyc.org/articulo.oa?id=77823404001

  6. World Health Organization. Plan de Acción sobre salud mental 2013–2020 [Internet]. Ginebra, Suiza: WHO; 2013. Available: http://apps.who.int/iris/bitstream/10665/97488/1/9789243506029_spa.pdf

  7. Fernandez, A., Saameno, J. A. B., Pinto-Meza, A., Luciano, J. V., Autonell, J., Palao, D. et al., Burden of chronic physical conditions and mental disorders in primary care. Br J Psychiatry 196:302–309, 2010. https://doi.org/10.1192/bjp.bp.109.074211.

    Article  PubMed  Google Scholar 

  8. Agencia Española de Medicamentos y productos sanitarios. Utilización de medicamentos antidepresivos en España durante el periodo 2000-2013. Informe de Utilización de Medicamentos U/AD/V1/14012015 [Internet]. España; 2015. Available: https://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antidepresivos-2000-2013.pdf

  9. NICE: National Institute for Health and Care Excellence. Depression in adults: recognition and management | Guidance and guidelines | NICE. In: Depression in adults: recognition and management of depression in adults [Internet]. NICE; 2009 [cited 2 Nov 2017]. Available: https://www.nice.org.uk/guidance/cg90

  10. Guia de Práctica Clínica sobre el Manejo de la Depresión en el Adulto. Ministerio de Sanidad S e IA de E de TS de G (avalia-t). Guía de Práctica Clínica sobre el Manejo de la Depresión en el Adulto [Internet]. 2014th ed. Guías de Práctica Clínica en el SNS: Avalia-t; 2013. Available: http://www.guiasalud.es/GPC/GPC_534_Depresion_Adulto_Avaliat_compl.pdf

  11. de Maat, S. M., Dekker, J., Schoevers, R. A., and de Jonghe, F., Relative efficacy of psychotherapy and combined therapy in the treatment of depression: A meta-analysis. Eur Psychiatry 22(1):1–8, 2007. https://doi.org/10.1016/j.eurpsy.2006.10.008.

    Article  PubMed  Google Scholar 

  12. Imel, Z. E., Malterer, M. B., McKay, K. M., and Wampold, B. E., A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. J Affect Disord 110(3):197–206, 2008. https://doi.org/10.1016/j.jad.2008.03.018.

    Article  PubMed  Google Scholar 

  13. Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., and Reynolds, C. F., The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: A meta-analysis of direct comparisons. World Psychiatry 12(2):137–148, 2013. https://doi.org/10.1002/wps.20038.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Raue, P. J., Schulberg, H. C., Heo, M., Klimstra, S., and Bruce, M. L., Patients’ depression treatment preferences and initiation, adherence, and outcome: A randomized primary care study. Psychiatr Serv. 60(3):337–343, 2009. https://doi.org/10.1176/ps.2009.60.3.337.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Prins, M. A., Verhaak, P. F. M., Bensing, J. M., and van der Meer, K., Health beliefs and perceived need for mental health care of anxiety and depression—The patients’ perspective explored. Clin Psychol Rev. 28(6):1038–1058, 2008. https://doi.org/10.1016/j.cpr.2008.02.009.

    Article  PubMed  Google Scholar 

  16. Sirera JP. EL PSICÓLOGO EN ATENCIÓN PRIMARIA: UN DEBATE NECESARIO EN EL SISTEMA NACIONAL DE SALUD. Papeles del Psicólogo. 2008;29: 271–290. Available: http://www.redalyc.org/articulo.oa?id=77829304

  17. Instituto Nacional de Estadística (INE). Encuesta sobre Equipamiento y Uso de Tecnologías de Información y Comunicación en los Hogares. Año 2014 [Internet]. Notas de Prensa; 2014. Available: http://www.ine.es/prensa/np864.pdf

  18. Felipe Soto-Perez, Manuel Franco C. M y F. J. Internet y Psicología Clínica: Revisión de las ciber-terapias. Rev Psicopatología y Psicol Clin. 2010;15: 19–37. Available: http://psicopedia.org/wp-content/uploads/2014/02/Internet-y-psicologia-clinica.pdf

  19. Proudfoot, J., Goldberg, D., Mann, A., Everitt, B., Marks, I., and Gray, J. A., Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychol med 33:217–227, 2003 Available: http://www.ncbi.nlm.nih.gov/pubmed/12622301.

    Article  CAS  Google Scholar 

  20. Proudfoot, J., Ryden, C., Everitt, B., Shapiro, D. A., Goldberg, D., Mann, A. et al., Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial. Br J psychiatry 185:46–54, 2004 Available: http://www.ncbi.nlm.nih.gov/pubmed/15231555.

    Article  Google Scholar 

  21. Cavanagh, K., and Shapiro, D. A., Computer treatment for common mental health problems. J Clin Psychol. 60(3):239–251, 2004. https://doi.org/10.1002/jclp.10261.

    Article  PubMed  Google Scholar 

  22. Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, et al. Computerised cognitive behaviour therapy for depression and anxiety update: A systematic review and economic evaluation. Health Technol assess. 2006;10: Iii, xi–xiv, 1-168. Available: http://www.ncbi.nlm.nih.gov/pubmed/16959169

  23. Barak A, Hen L, Boniel-Nissim M, Shapira N. A comprehensive review and a meta-analysis of the effectiveness of Internet-based psychotherapeutic interventions. Database Abstr Rev Eff Qual Rev [Internet]. Centre for Reviews and Dissemination (UK); 2008; Available: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026877/

    Article  Google Scholar 

  24. Andersson, G., and Cuijpers, P., Internet-based and other computerized psychological treatments for adult depression: A meta-analysis. Cogn Behav Ther. 38(4):196–205, 2009. https://doi.org/10.1080/16506070903318960.

    Article  PubMed  Google Scholar 

  25. Wallen, M. P., Gomersall, S. R., Keating, S. E., Wisløff, U., and Coombes, J. S., Accuracy of heart rate watches: Implications for weight management. Public Library of Science 11(5):e0154420, 2016. https://doi.org/10.1371/journal.pone.0154420.

    Article  CAS  Google Scholar 

  26. Andrews G, Cuijpers P, Craske M. G, McEvoy P, Titov N. Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis. Baune B. T, editor.. Public Library of Science; 2010;5: e13196. https://doi.org/10.1371/journal.pone.0013196, 10

    Article  Google Scholar 

  27. Cuijpers, P., Donker, T., van Straten, A., Li, J., and Andersson, G., Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies. Psychol Med. 40(12):1943–1957, 2010. https://doi.org/10.1017/S0033291710000772.

    Article  CAS  PubMed  Google Scholar 

  28. Hoifodt, R. S., Strom, C., Kolstrup, N., Eisemann, M., and Waterloo, K., Effectiveness of cognitive behavioural therapy in primary health care: A review. Fam Pract. 28(5):489–504, 2011. https://doi.org/10.1093/fampra/cmr017.

    Article  PubMed  Google Scholar 

  29. Newman, M. G., Szkodny, L. E., Llera, S. J., and Przeworski, A., A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: Is human contact necessary for therapeutic efficacy? Clin Psychol Rev. 31(1):89–103, 2011. https://doi.org/10.1016/j.cpr.2010.09.008.

    Article  PubMed  Google Scholar 

  30. So, M., Yamaguchi, S., Hashimoto, S., Sado, M., Furukawa, T. A., and McCrone, P., Is computerised CBT really helpful for adult depression?-a meta-analytic re-evaluation of CCBT for adult depression in terms of clinical implementation and methodological validity. BMC Psychiatry. 13:113, 2013. https://doi.org/10.1186/1471-244X-13-113.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Andersson, G., Cuijpers, P., Carlbring, P., Riper, H., and Hedman, E., Guided internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: A systematic review and meta-analysis. World Psychiatry. 13(3):288–295, 2014. https://doi.org/10.1002/wps.20151.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Linde, K., Sigterman, K., Kriston, L., Rucker, G., Jamil, S., Meissner, K. et al., Effectiveness of psychological treatments for depressive disorders in primary care: Systematic review and meta-analysis. Ann Fam Med. 13(1):56–68, 2015. https://doi.org/10.1370/afm.1719.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Clarke, G., Reid, E., Eubanks, D., O’Connor, E., DeBar, L. L., Kelleher, C. et al., Overcoming depression on the internet (ODIN): A randomized controlled trial of an internet depression skills intervention program. J Med Internet Res. 4(3):e14, 2002. https://doi.org/10.2196/jmir.4.3.e14.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Clarke, G., Eubanks, D., Reid, E., Kelleher, C., O’Connor, E., DeBar, L. L. et al., Overcoming Depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. Journal of Medical Internet Research 7(2):e16, 2005. https://doi.org/10.2196/jmir.7.2.e16.

    Article  PubMed  PubMed Central  Google Scholar 

  35. ANDERSSON, G., Bergström, J., Holländare, F., Carlbring, P., Kaldo, V., and Ekselius, L., Internet-based self-help for depression: Randomised controlled trial. Br J Psychiatry. 187:456–461, 2005. https://doi.org/10.1192/bjp.187.5.456.

    Article  PubMed  Google Scholar 

  36. van Straten, A., Cuijpers, P., and Smits, N., Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: Randomized controlled trial. J Med Internet Res. 10(1):e7, 2008. https://doi.org/10.2196/jmir.954.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Warmerdam, L., van Straten, A., Twisk, J., Riper, H., and Cuijpers, P., Internet-based treatment for adults with depressive symptoms: randomized controlled trial. Journal of Medical Internet Research 10(4):e44, 2008. https://doi.org/10.2196/jmir.1094.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Ruwaard, J., Schrieken, B., Schrijver, M., Broeksteeg, J., Dekker, J., Vermeulen, H., and Lange, A., Standardized web-based cognitive Behavioural therapy of mild to moderate depression: A randomized controlled trial with a long-term follow-up. Cogn Behav Ther. 38(4):206–221, 2009. https://doi.org/10.1080/16506070802408086.

    Article  PubMed  Google Scholar 

  39. Waller, R., and Gilbody, S., Barriers to the uptake of computerized cognitive behavioural therapy: A systematic review of the quantitative and qualitative evidence. Psychol Med. 39:705, 2009. https://doi.org/10.1017/S0033291708004224.

    Article  CAS  PubMed  Google Scholar 

  40. Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S. et al., Therapist-delivered internet psychotherapy for depression in primary care: A randomised controlled trial. Lancet. 374:628–634, 2009. https://doi.org/10.1016/S0140-6736(09)61257-5.

    Article  PubMed  Google Scholar 

  41. Titov N, Andrews G, Davies M, McIntyre K, Robinson E, Solley K. Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance. García A. V, editor. PLoS One. 2010;5: e10939. https://doi.org/10.1371/journal.pone.0010939

    Article  Google Scholar 

  42. de Graaf, L. E., Gerhards, S. A. H., Arntz, A., Riper, H., Metsemakers, J. F. M., Evers, S. M. A. A. et al., Clinical effectiveness of online computerised cognitive-behavioural therapy without support for depression in primary care: Randomised trial. Br J Psychiatry. 195:73–80, 2009. https://doi.org/10.1192/bjp.bp.108.054429.

    Article  PubMed  Google Scholar 

  43. Meyer, B., Berger, T., Caspar, F., Beevers, C. G., Andersson, G., and Weiss, M., Effectiveness of a novel integrative online treatment for depression (Deprexis): Randomized controlled trial. J Med Internet Res. 11(2):e15, 2009. https://doi.org/10.2196/jmir.1151.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Vernmark, K., Lenndin, J., Bjärehed, J., Carlsson, M., Karlsson, J., Öberg, J. et al., Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression. Behav Res Ther. 48:368–376, 2010. https://doi.org/10.1016/j.brat.2010.01.005.

    Article  PubMed  Google Scholar 

  45. Wagner, B., Horn, A. B., and Maercker, A., Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. J Affect Disord. 152–154:113–121, 2014. https://doi.org/10.1016/j.jad.2013.06.032.

    Article  PubMed  Google Scholar 

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Acknowledgements

This research has been partially supported by the European Commission and the Ministry of Industry, Energy and Tourism under the project AAL-20125036 named “WetakeCare: ICT- based Solution for (Self-) Management of Daily Living”.

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Authors and Affiliations

  1. School of Medicine, Director of the Insular Plan of Psychosocial Rehabilitation, University of La Laguna, La Laguna, Spain

    Francisco Rodriguez-Pulido

  2. Department of Signal Theory and Communications, Telematics Engineering University of Valladolid, Paseo de Belén, 15, 47011, Valladolid, Spain

    Gema Castillo & Isabel de la Torre-Díez

  3. Bretagne Loire and Nantes Universities, UMR 6164, IETR Polytech Nantes, Rennes, France

    Sofiane Hamrioui

  4. Medical Family, Collaborative Area Psychiatry. School of Medicine, University of La Laguna, La Laguna, Spain

    Laura Delgado Martin & Pilar Vazquez-Beltrán

  5. Department of the Zamora Hospital, University Rio Hortega Hospital (Valladolid), Valladolid, Spain

    Manuel A. Franco-Martín

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  1. Francisco Rodriguez-Pulido
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Correspondence to Isabel de la Torre-Díez.

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Rodriguez-Pulido, F., Castillo, G., Hamrioui, S. et al. Treatment of Depression in Primary Care with Computerized Psychological Therapies: Systematic Reviews. J Med Syst 44, 67 (2020). https://doi.org/10.1007/s10916-020-1543-7

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