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Computerized cognitive behavioral therapy supported by a peer specialist with lived experience (PS-cCBT) appears to be modestly beneficial for improving short-term depression symptoms, as well as long-term recovery, in patients with newly diagnosed depression, according to a study published in Psychiatric Services.
Primary care patients in the US Department of Veterans Affairs (VA) who received a new diagnosis of depression were identified through electronic medical records databases. Patients underwent a telephone screening, and those who had a score of ≥10 on the Patient Health Questionnaire-9 and who possessed basic Internet and computer usage skills were recruited. The investigators randomly assigned patients to either a 3-month PS-cCBT program (n=167) or a usual care control condition (n=163). Differences in depression symptoms, general mental health status, quality of life, and mental health recovery between the 2 groups were assessed at baseline as well as at 3-month and 6-month follow-up.
At 3 months, participants randomly assigned to PS-cCBT had a 1.4-point (95% CI, 0.3-2.5 points; P =.01) greater improvement in symptoms of depression vs the control group. No difference between the 2 groups was observed at 6 months, suggesting a potential lack of sustained benefit over time.
Quality of life was improved to a significantly greater degree at 3 months with PS-cCBT compared with usual care (2.6 points; 95% CI, 0.5-4.8 points; P =.02). However, similar to the improvement in depression symptoms, there was no difference between the 2 groups at 6 months in terms of quality of life. Patients who received PS-cCBT did have greater improvement in mental health recovery at both 3 months (3.6 points; 95% CI, 0.9-6.2 points; P =.01) and 6 months (4.5 points; 95% CI, 1.2-7.7 points; P =.01).
Limitations of the study included the high rate of refusals, as well as the inclusion of mostly men from the VA. “PS-cCBT should be considered as an initial treatment enhancement to improve effectiveness of primary care treatment of depression,” the study authors concluded.
Reference
Pfeiffer PN, Pope B, Houck M, et al. Effectiveness of peer-supported computer-based CBT for depression among veterans in primary care [published online January 14, 2020]. Psychiatr Serv. doi:10.1176/appi.ps.201900283
