000095414 001__ 95414
000095414 005__ 20231219145818.0
000095414 0247_ $$2doi$$a10.2196/15845
000095414 0248_ $$2sideral$$a118637
000095414 037__ $$aART-2020-118637
000095414 041__ $$aeng
000095414 100__ $$aGili, M.
000095414 245__ $$aEfficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial
000095414 260__ $$c2020
000095414 5060_ $$aAccess copy available to the general public$$fUnrestricted
000095414 5203_ $$aBACKGROUND: Primary care is a major access point for the initial treatment of depression, but the management of these patients is far from optimal. The lack of time in primary care is one of the major difficulties for the delivery of evidence-based psychotherapy. During the last decade, research has focused on the development of brief psychotherapy and cost-effective internet-based interventions mostly based on cognitive behavioral therapy (CBT). Very little research has focused on alternative methods of treatment for depression using CBT. Thus, there is a need for research into other therapeutic approaches. OBJECTIVE: This study aimed to assess the effectiveness of 3 low-intensity, internet-based psychological interventions (healthy lifestyle psychoeducational program [HLP], focused program on positive affect promotion [PAPP], and brief intervention based on mindfulness [MP]) compared with a control condition (improved treatment as usual [iTAU]). METHODS: A multicenter, 4-arm, parallel randomized controlled trial was conducted between March 2015 and March 2016, with a follow-up of 12 months. In total, 221 adults with mild or moderate major depression were recruited in primary care settings from 3 Spanish regions. Patients were randomly distributed to iTAU (n=57), HLP (n=54), PAPP (n=56), and MP (n=54). All patients received iTAU from their general practitioners. The main outcome was the Spanish version of the Patient Health Questionnaire-9 (PHQ-9) from pretreatment (time 1) to posttreatment (time 2) and up to 6 (time 3) and 12 (time 4) months'' follow-up. Secondary outcomes included the visual analog scale of the EuroQol, the Short-Form Health Survey (SF-12), the Positive and Negative Affect Schedule (PANAS), and the Pemberton Happiness Index (PHI). We conducted regression models to estimate outcome differences along study stages. RESULTS: A moderate decrease was detected in PHQ-9 scores from HLP (ß=-3.05; P=.01) and MP (ß=-3.00; P=.01) compared with iTAU at posttreatment. There were significant differences between all intervention groups and iTAU in physical SF-12 scores at 6 months after treatment. Regarding well-being, MP and PAPP reported better PHI results than iTAU at 6 months post treatment. PAPP intervention significantly decreased PANAS negative affect scores compared with iTAU 12 months after treatment. CONCLUSIONS: The low-intensity, internet-based psychological interventions (HLP and MP) for the treatment of depression in primary care are more effective than iTAU at posttreatment. Moreover, all low-intensity psychological interventions are also effective in improving medium- and long-term quality of life. PAPP is effective for improving health-related quality of life, negative affect, and well-being in patients with depression. Nevertheless, it is important to examine possible reasons that could be implicated for PAPP not being effective in reducing depressive symptomatology; in addition, more research is still needed to assess the cost-effectiveness analysis of these interventions.
000095414 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/PI13-01171
000095414 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000095414 590__ $$a5.428$$b2020
000095414 591__ $$aMEDICAL INFORMATICS$$b5 / 30 = 0.167$$c2020$$dQ1$$eT1
000095414 591__ $$aHEALTH CARE SCIENCES & SERVICES$$b10 / 107 = 0.093$$c2020$$dQ1$$eT1
000095414 592__ $$a1.446$$b2020
000095414 593__ $$aHealth Informatics$$c2020$$dQ1
000095414 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000095414 700__ $$aCastro, A.
000095414 700__ $$aGarcía-Palacios, A.
000095414 700__ $$0(orcid)0000-0002-3797-4218$$aGarcia-Campayo, J.$$uUniversidad de Zaragoza
000095414 700__ $$aMayoral-Cleries, F.
000095414 700__ $$aBotella, C.
000095414 700__ $$aRoca, M.
000095414 700__ $$0(orcid)0000-0002-2116-9257$$aBarceló-Soler, A.
000095414 700__ $$aHurtado, M.M.
000095414 700__ $$0(orcid)0000-0003-4842-0453$$aNavarro, M.$$uUniversidad de Zaragoza
000095414 700__ $$aVillena, A.
000095414 700__ $$aPérez-Ara, M.Á.
000095414 700__ $$aRiera-Serra, P.
000095414 700__ $$aBaños, R.M.
000095414 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría
000095414 7102_ $$14009$$2735$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicolog.Evolut.Educac
000095414 773__ $$g22, 6 (2020), e15845 [20 pp.]$$pJMIR, J. med. internet res.$$tJournal of Medical Internet Research$$x1438-8871
000095414 8564_ $$s270350$$uhttps://zaguan.unizar.es/record/95414/files/texto_completo.pdf$$yVersión publicada
000095414 8564_ $$s470269$$uhttps://zaguan.unizar.es/record/95414/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000095414 909CO $$ooai:zaguan.unizar.es:95414$$particulos$$pdriver
000095414 951__ $$a2023-12-19-14:44:50
000095414 980__ $$aARTICLE