Effectiveness of an Internet-based Intervention for the Treatment of Depression: Towards the Improvement of the Management of Depression
Overview
- Phase
- Not Applicable
- Intervention
- ASCENSO
- Conditions
- Depression
- Sponsor
- Instituto Milenio para Investigación en Depresión y Personalidad
- Enrollment
- 167
- Locations
- 1
- Primary Endpoint
- Change in depressivity assessed with the Beck's Depression Inventory I (BDI-I)
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Depression is a highly prevalent disorder in Chile, generating important personal and social costs. This study aims to evaluate the effectiveness of the internet-based program ASCENSO as an adjunct intervention for the treatment of depression. ASCENSO provides information to promote patients' self-care, it monitors reported depression symptoms providing automatized feedback and provides the possibility of booking a counseling session via chat or by phone. To evaluate the effectiveness of ASCENSO, an open, evaluator-blind, prospective, parallel-group (one intervention group and one active control group) randomized controlled trial will be implemented in one mental health center in Santiago of Chile. The sample will be composed of adults initiating treatment for depression, and who have internet access. Participants will be randomly assigned to one of the two study arms. Randomization will be stratified by the number of patients´ previous episodes (dichotomized into none, 1 or more), following a permuted block randomization procedure. Patients in the experimental group (n=100) will receive the usual treatment plus access to the ASCENSO program. The control group (n=100) will only receive the usual treatment. At recruitment, months 6 and 9, patients' self-reported depression symptoms and quality of life will be assessed. Additionally, adherence to treatment in terms of patients' attendance to medical controls and psychotherapy sessions will be registered for both research groups.
Detailed Description
The public health system has established policies and priorities to provide access to depression treatment and to improve the quality of those services. The acknowledgment of the complexity and chronicity of the disorder has motivated the design and implementation of comprehensive disease management strategies for depression. There are experiences that show that information technologies can help to optimize the management of depression. If ASCENSO is effective, it could be a useful resource to include to the mental health services for depression in Chile. The components of the ASCENSO program are: Emergency. Standard Information on what to do and who to contact in a crisis situation. Online or phone counseling. Patients can schedule a 30-minute session with a psychologist, which is conducted in a private text chatroom or over the phone. Monitoring. Patients receive a bi-weekly email with a link to the monitoring questionnaire and automatized tailored feedback message. If a participant reports severe impairment, the ASCENSO administrator receives an alert notification and then contacts the patient. Self-care information and blog. Web pages with basic information about depression and self-care recommendations.
Investigators
Álvaro Carrasco
Researcher
Instituto Milenio para Investigación en Depresión y Personalidad
Eligibility Criteria
Inclusion Criteria
- •Clinical diagnosis of major depression disorder
- •Internet access
Exclusion Criteria
- •previous suicide attempt
- •hospitalization for a previous depressive episode
- •a history of psychotic symptoms
- •bipolar disorder
- •organic brain disorders
- •any serious disorders related to substance abuse or dependence
- •antisocial personality disorder
- •a serious medical condition or severe cognitive impairment
- •lack of knowledge of the Spanish language
- •illiteracy
Arms & Interventions
Experimental
Participants receive psychiatric treatment and psychotherapy as usual. In addition, participants have access to the internet-based program ASCENSO: an adjunct support and monitoring system for the treatment of depression.
Intervention: ASCENSO
Experimental
Participants receive psychiatric treatment and psychotherapy as usual. In addition, participants have access to the internet-based program ASCENSO: an adjunct support and monitoring system for the treatment of depression.
Intervention: Antidepressants or in combination with anxiolytics, neuroleptics or mood stabilizers.
Experimental
Participants receive psychiatric treatment and psychotherapy as usual. In addition, participants have access to the internet-based program ASCENSO: an adjunct support and monitoring system for the treatment of depression.
Intervention: Psychotherapy
Control
Patients receive psychiatric treatment and psychotherapy as usual.
Intervention: Antidepressants or in combination with anxiolytics, neuroleptics or mood stabilizers.
Control
Patients receive psychiatric treatment and psychotherapy as usual.
Intervention: Psychotherapy
Outcomes
Primary Outcomes
Change in depressivity assessed with the Beck's Depression Inventory I (BDI-I)
Time Frame: Baseline, months 6 and 9.
Beck's Depression Inventory I (BDI-I) total score (score range 0 - 63)
Secondary Outcomes
- Change in quality of life change assessed with the EuroQol/EQ-5D(Baseline, months 6 and 9.)