People who may be sliding toward depression might be able to prevent the full-blown disorder by completing some self-help exercises online, a new study suggests.
Researchers found that men and women who had some symptoms of depression and used a web-based mental health program that was supported by an online trainer were less likely to experience a major depressive episode during a 1-year follow-up period, compared with people who also had symptoms of depression but were only given online access to educational materials about the signs of depression and its treatment. The findings were published today (May 3) in the journal JAMA.
The results of the study suggest that a web-based, guided self-help intervention could effectively reduce the risk of major depressive disorder or at least delay its onset, said lead study author Claudia Buntrock, a doctoral student in psychology at Leuphana University in Lueneburg, Germany.
In the study, the researchers tracked about 400 adults in Germany who met the criteria for having some symptoms of depression but were not considered to have a major depressive disorder. The participants had not received any psychotherapy in the six months prior to enrolling in the study.
About half the participants were assigned to participate in a web-based training program that taught them behavioral and problem-solving skills, such as how to brainstorm solutions to a problem, make time for enjoyable activities and practice relaxation techniques. The program consisted of six half-hour sessions and self-help exercises, along with support from an online trainer who offered written feedback to participants after each session.
The rest of the study participants had access to online information about depression, but there were no exercises for them to complete and no trainers were involved.
When researchers followed up by telephone with the study participants one year later, they found that 27 percent of the people in the online self-help group experienced symptoms of major depression, compared to 41 percent of the people in the group that simply had access to information.
The findings show that the delivery of preventive mental health interventions via the Internet may be a promising way to reach individuals who are at an early stage of depression, and that it may also help prevent their transition to a full-blown depressive disorder, Buntrock told Live Science. Online programs cost less than traditional mental health services and allow participants to work through the information and exercises at their own pace, according to the study.
In addition, since research is showing that treatments for major depression are not always successful at improving health outcomes — such as premature death and disability — its prevention is becoming more important, the researchers said.
The researchers said that one of the limitations of the study is that they could not rule out the additional attention that some participants received as a result of feedback from the online trainer could be a factor in that group's reduced risk for depression.
Future studies should clarify whether web-based, guided self-help programs are effective at preventing the first onsetof depression as well as its recurrence, Buntrock said.
She also said that because individualized feedback from an online trainer can make the specific training program harder to replicate with a larger number of participants, more studies are needed to evaluate the preventive effects of a web-based intervention that does not have any online trainers helping participants.
The online, self-help program developed for this study is currently in use by a health insurance company in Germany. That company was involved in the research and made the program available to its members who might be at risk for depression, Buntrock said.