Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial

• HIT Description: patient decision support / consumer health informatics More info...
  
• Purpose of Study: determine the impact of clinical and demographic variables on the efficacy of a computerized cognitive-behavioural therapy (CBT) program for anxiety and depression
  
• Years of study: Not Available
  
• Study Design: RCT
  
• Outcomes: impact on health care effectiveness and quality
  

• Settings: patients aged 18-75 with depression, mixed anxiety and depression or anxiety disorder not currently receiving psychological treatment recruited from general practices in London and southeast England
• Intervention: patients scoring higher than 3 on the General Health Questionnaire and higher than 11 on the Clinical Interview Schedule Ð Revised were randomized after evaluation by their general practitioner to the computerized CBT program or to usual care
• Evaluation Method: questionnaires including the Beck Depression Inventory II, the Work and Social Adjustment Scale, and the Attributional Style Questionnaire
• Description: interactive, multimedia, computerized CBT package consisting of a 15 minute introductory video followed by eight therapy sessions
• Strategy: a nurse checked that the patient had logged on successfully at the beginning of each session and ensured that the patient had the necessary print-outs at the end of the session
• Quality of Care and Patient Safety Outcome: The computerized CBT program improved depression, negative attributional style, and work and social adjustment and was not affected by whether patients were prescribed drugs or by length or severity of illness. Anxiety and positive attributional style also improved with CBT and improved more for more disturbed patients.