Internet interventions for depression: new developments
- PMID: 27489460
- PMCID: PMC4969707
- DOI: 10.31887/DCNS.2016.18.2/jschroeder
Internet interventions for depression: new developments
Abstract
A wide range of Internet interventions, mostly grounded in methods of cognitive behavioral therapy, have been developed and tested for several mental disorders. The evidence to date shows that these interventions are effective in reducing symptoms of depression. Metaanalyses report small-to-medium effect sizes when Internet interventions are delivered as stand-alone self-help interventions (d=0.25-0.36), and medium-to-large effect sizes when delivered as therapist-guided interventions (d=0.58-0.78), both compared with usual care. Only a minority of people suffering from depression receive adequate treatment, and Internet interventions might help bridge the large treatment gap. This review summarizes the current body of evidence and highlights pros and cons of Internet interventions. It also outlines how they could be implemented in mental health care systems and points out unresolved questions, as well as future directions, in this research field.
Se ha desarrollado y probado una amplia gama de intervenciones por internet para diversos trastornos mentales y la mayor parte está basada en métodos de terapia cognitivo conductual. A la fecha la evidencia muestra que estas intervenciones son efectivas para reducir síntomas depresivos. Estudios de meta-análisis dan cuenta de efectos de pequeña a mediana cuantía cuando las intervenciones por internet son proporcionadas como intervenciones de auto-ayuda de forma autónoma (d=0,25-0,36), y efectos de mediana a gran cuantía cuando son proporcionadas como intervenciones guiadas por terapeutas (d=0,58-0,78), en ambos casos en comparación con el tratamiento habitual. Sólo una minoría de las personas que sufre una depresión recibe un tratamiento adecuado y las intervenciones por internet podrían ayu-dar a reducir la gran brecha terapéutica. En este campo de investigación la presente revisión resume el cuerpo actual de evidencia de las intervenciones por internet y destaca los pros y contras de ellas. También bosqueja cómo podrían ser implementadas estas intervenciones en los sistemas de atención de salud y señala tanto preguntas sin resolver como futuras orientaciones.
Un large éventail de procédures Internet, dont la plupart sont fondées sur des méthodes de thérapie cognitivo-comportementale, ont été développées et testées pour plusieurs troubles mentaux. À ce jour, les données montrent que ces programmes sont efficaces pour réduire les symptômes dépressifs. Des métaanalyses rapportent que, comparées à un traitement classique, les procédures Internet délivrées en tant que programmes indépendants d'auto-assistance ont un effet de faible ampleur à moyenne ampleur (d = 0,25-0,36) et un effet de moyenne ampleur à forte ampleur lorsqu'il s'agit de programmes menés par un thérapeute (d = 0,58-0,78). Seule une minorité de personnes souffrant de dépression sont correctement traitées, et les procédures Internet peuvent aider à combler l'écart important (d'observance) du traitement. Cet article résume l'état actuel des connaissances et souligne les avantages et les inconvénients des procédures utilisant l'Internet. Il décrit aussi la façon dont elles pourraient être mises en oeuvre dans les systèmes de santé mentale et indique les questions non résolues, ainsi que les axes de recherche à venir dans ce domaine.
Keywords: Internet intervention; depression; iCBT; review.
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