Advertisement

Applied Research in Quality of Life

, Volume 14, Issue 5, pp 1301–1313 | Cite as

Quality of Life Outcomes in Internet-Delivered (Space from Depression) Treatment for Depression

  • A. Enrique
  • J. Burke
  • D. RichardsEmail author
  • L. Timulak
Article
  • 190 Downloads

Abstract

Quality of Life (QoL) outcomes in interventions for depression are an area in the literature that has received little focus, particularly in trials relating to internet-delivered psychological interventions. Evaluating QoL outcomes are necessary to more completely understand if an intervention is successful in the treatment of depression, given that a decrease in negative symptoms in depression does not equate to synonymous increase in QoL. This secondary analysis study is aimed to examine the effects of an internet-delivered intervention for a mild to moderate depressed sample on QoL. 188 participants were randomly allocated to the Space from Depression intervention (n = 96) or a waiting-list group (n = 92). The intervention is an eight-module online cognitive-behavioural therapy intervention for depression. The trial had a duration of 8 weeks and the results were explored up to 3 months later. QoL was measured using the EuroQol-5D (EQ-5D) at different time points. The intervention produced positive effects in the global scores of QoL at post-treatment an these results were maintained at follow-up, although no differences between conditions were found. Analyses of the QoL dimensions showed a significant improvement on the Anxiety/depression dimension compared to controls, but no effects were found in other dimensions. The results suggest that internet-delivered interventions has the potential to produce changes in QoL. These results can potentially be understood by the lower impairments within a mild to moderate depressed sample. Further inferences about the sensitivity of the EQ-5D measure within this population are discussed in light of the findings.

Keywords

Quality of life Internet-delivered interventions EQ-5D Depression 

Notes

Funding

This study was funded by SilverCloud Health.

Compliance with Ethical Standards

Conflict of Interest

Authors A, B & C are employees of SilverCloud health, developers of computerized psychological interventions for depression and anxiety, stress and comorbid long-term conditions. Author D declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Angermeyer, M. C., Holzinger, A., Matschinger, H., & Stengler-Wenzke, K. (2002). Depression and quality of life: Results of a follow-up study. International Journal of Social Psychiatry, 48(3), 189–199.  https://doi.org/10.1177/002076402128783235.CrossRefGoogle Scholar
  2. Beck, A. T., & Alford, B. A. (2009). Depression: causes and treatment (2nd ed.). Philadelphia: University of Pennsylvania Press.Google Scholar
  3. Berger, T., Hämmerli, K., Gubser, N., Andersson, G., & Caspar, F. (2011). Internet-based treatment of depression: A randomized controlled trial comparing guided with unguided self-help. Cognitive Behaviour Therapy, 40(4), 251–266.  https://doi.org/10.1080/16506073.2011.616531.CrossRefGoogle Scholar
  4. Botella, J., & Sánchez-Meca, J. (2015). Meta-análisis en ciencias sociales y de la salud. Madrid: Síntesis.Google Scholar
  5. Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155.CrossRefGoogle Scholar
  6. Corring, D. J., & Cook, J. V. (2007). Use of qualitative methods to explore the quality-of-life construct from a consumer perspective. Psychiatric Services, 58(2), 240–244.  https://doi.org/10.1176/appi.ps.58.2.240.CrossRefGoogle Scholar
  7. Cowpertwait, L., & Clarke, D. (2013). Effectiveness of web-based psychological interventions for depression: A meta-analysis. International Journal of Mental Health and Addiction, 11(2), 247–268.  https://doi.org/10.1007/s11469-012-9416-z.CrossRefGoogle Scholar
  8. Cuijpers, P., van Straten, A., Warmerdam, L., & Andersson, G. (2009). Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: A meta-analysis. Depression and Anxiety, 26(3), 279–288.  https://doi.org/10.1002/da.20519.CrossRefGoogle Scholar
  9. Dear, B. F., Zou, J. B., Ali, S., Lorian, C. N., Johnston, L., Terides, M. D., ... & Titov, N. (2015). Examining self-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety and depression: two feasibility open trials. Internet Interventions, 2(1), 17–23.Google Scholar
  10. Devlin, N., Parkin, D., & Browne, J. (2009). Using the EQ-5D as a performance measurement tool in the NHS (report no. 09/03). London: Department of Economics, City University London.Google Scholar
  11. Dixon, P., Hollinghurst, S., Edwards, L., Thomas, C., Foster, A., Davies, B., ... & Salisbury, C. (2016). Cost-effectiveness of telehealth for patients with depression: evidence from the Healthlines randomised controlled trial. British Journal of Psychiatry Open, 2(4), 262–269.Google Scholar
  12. Dolan, P., Gudex, C., Kind, P., & Williams, A. (1995). A Social Tariff for EuroQoL: Results from a UK General Population Survey. CHE discussion paper. York: Centre for Health Economics.Google Scholar
  13. Feng, Y., Devlin, N., & Herdman, M. (2015). Assessing the health of the general population in England: How do the three-and five-level versions of EQ-5D compare? Health and Quality of Life Outcomes, 13(1), 171.CrossRefGoogle Scholar
  14. Furukawa, T. A., McGuire, H., & Barbui, C. (2002). Meta-analysis of effects and side effects of low dosage tricyclic antidepressants in depression: Systematic review. British Medical Journal, 325(7371), 991–999.  https://doi.org/10.1136/bmj.325.7371.991.CrossRefGoogle Scholar
  15. Hallgren, M., Kraepelien, M., Öjehagen, A., Lindefors, N., Zeebari, Z., Kaldo, V., & Forsell, Y. (2015). Physical exercise and internet-based cognitive–behavioural therapy in the treatment of depression: Randomised controlled trial. The British Journal of Psychiatry, 207(3), 227–234.CrossRefGoogle Scholar
  16. Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.CrossRefGoogle Scholar
  17. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.  https://doi.org/10.1007/s10608-012-9476-1.CrossRefGoogle Scholar
  18. IsHak, W. W., Greenberg, J. M., Balayan, K., Kapitanski, N., Jeffrey, J., Fathy, H., Fakhry, H., & Rapaport, M. H. (2011). Quality of life: The ultimate outcome measure of interventions in major depressive disorder. Harvard Review of Psychiatry, 19(5), 229–239.  https://doi.org/10.3109/10673229.2011.614099.CrossRefGoogle Scholar
  19. IsHak, W. W., Bonifay, W., Collison, K., Reid, M., Youssef, H., Parisi, T., Cohen, R. M., & Cai, L. (2017). The recovery index: A novel approach to measuring recovery and predicting remission in major depressive disorder. Journal of Affective Disorders, 208, 369–374.  https://doi.org/10.1016/j.jad.2016.08.081.CrossRefGoogle Scholar
  20. Janssen, M. F., Birnie, E., Haagsma, J. A., & Bonsel, G. J. (2008). Comparing the standard EQ-5D three-level system with a five-level version. Value in Health, 11(2), 275–284.  https://doi.org/10.1111/j.1524-4733.2007.00230.x.CrossRefGoogle Scholar
  21. Jha, M. K., Greer, T. L., Grannemann, B. D., Carmody, T., Rush, A. J., & Trivedi, M. H. (2016). Early normalization of quality of life predicts later remission in depression: Findings from the CO-MED trial. Journal of Affective Disorders, 206, 17–22.CrossRefGoogle Scholar
  22. Johansson, R., & Andersson, G. (2012). Internet-based psychological treatments for depression. Expert Review of Neurotherapeutics, 12(7), 861–870.  https://doi.org/10.1586/ern.12.63.CrossRefGoogle Scholar
  23. Kind, P., Hardman, G., & Macran, S. (1999). UK population norms for EQ-5D: discussion paper (Report No. 172). York: Centre for Health Economics, The University of York.Google Scholar
  24. Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). Bulletin of the World Health Organization, 82(11), 858–866 Retrieved from: http://www.scielosp.org/pdf/bwho/v82n11/v82n11a11.pdf.Google Scholar
  25. Kolovos, S., Kleiboer, A., & Cuijpers, P. (2016). Effect of psychotherapy for depression on quality of life: Meta-analysis. The British Journal of Psychiatry.  https://doi.org/10.1192/bjp.bp.115.175059.
  26. Mira, A., Bretón-López, J., García-Palacios, A., Quero, S., Baños, R. M., & Botella, C. (2017). An internet-based program for depressive symptoms using human and automated support: A randomized controlled trial. Neuropsychiatric Disease and Treatment, 13, 987–1006.  https://doi.org/10.2147/ndt.s130994.CrossRefGoogle Scholar
  27. Orley, J., Saxena, S., & Herman, H. (1998). Quality of life and mental illness. Reflections from the perspective of the WHOQOL. The British Journal of Psychiatry, 172(4), 291–293.  https://doi.org/10.1192/bjp.172.4.291.CrossRefGoogle Scholar
  28. Papakostas, G. I., Petersen, T., Mahal, Y., Mischoulon, D., Nierenberg, A. A., & Fava, M. (2004). Quality of life assessments in major depressive disorder: A review of the literature. General Hospital Psychiatry, 26(1), 13–17.  https://doi.org/10.1016/j.genhosppsych.2003.07.004.CrossRefGoogle Scholar
  29. Parkin, D., Rice, N., & Devlin, N. (2010). Statistical analysis of EQ-5D profiles: Does the use of value sets bias inference? Medical Decision Making, 30(5), 556–565.CrossRefGoogle Scholar
  30. Rabin, R., & Charro, F. D. (2001). EQ-SD: A measure of health status from the EuroQol group. Annals of Medicine, 33(5), 337–343.  https://doi.org/10.3109/07853890109002087.CrossRefGoogle Scholar
  31. Richards, D., & Richardson, T. (2012). Computer-based psychological treatments for depression: A systematic review and meta-analysis. Clinical Psychology Review, 32(4), 329–342.  https://doi.org/10.1016/j.cpr.2012.02.004.CrossRefGoogle Scholar
  32. Richards, D., Timulak, L., Doherty, G., Sharry, J., Colla, A., Joyce, C., & Hayes, C. (2014). Internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression: Protocol for a randomized controlled trial. BMC Psychiatry, 14(1), 147.  https://doi.org/10.1186/1471-244X-14-147.CrossRefGoogle Scholar
  33. Richards, D., Timulak, L., O'Brien, E., Hayes, C., Vigano, N., Sharry, J., & Doherty, G. (2015). A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression. Behaviour Research and Therapy, 75, 20–31.CrossRefGoogle Scholar
  34. Rozental, A., Magnusson, K., Boettcher, J., Andersson, G., & Carlbring, P. (2017). For better or worse: An individual patient data meta-analysis of deterioration among participants receiving internet-based cognitive behavior therapy. Journal of Consulting and Clinical Psychology, 85(2), 160.CrossRefGoogle Scholar
  35. van Zoonen, K., Buntrock, C., Ebert, D. D., Smit, F., Reynolds, C. F., Beekman, A. T., & Cuijpers, P. (2014). Preventing the onset of major depressive disorder: A meta-analytic review of psychological interventions. International Journal of Epidemiology, 43(2), 318–329.  https://doi.org/10.1093/ije/dyt175.CrossRefGoogle Scholar
  36. World Health Organization. (2004). Promoting mental health. Concepts, emerging evidence, practice (Summary report). Geneva: World Health Organization.Google Scholar
  37. World Health Organization. (2012). Depression: a global public health concern. Geneva: World Health Organization. Retrieved from: http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf.
  38. Zikmund, V. (2003). Health, well-being, and the quality of life: Some psychosomatic reflections. Neuro Endocrinology Letters, 24(6), 401.Google Scholar
  39. Zimmerman, M., Mcglinchey, J. B., Posternak, M. A., Friedman, M., Attiullah, N., & Boerescu, D. (2006). How should remission from depression be defined? The depressed patient's perspective. The American Journal of Psychiatry, 163, 148–150.  https://doi.org/10.1176/appi.ajp.163.1.148.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. and The International Society for Quality-of-Life Studies (ISQOLS) 2018

Authors and Affiliations

  • A. Enrique
    • 1
    • 2
  • J. Burke
    • 1
    • 2
  • D. Richards
    • 1
    • 2
    Email author
  • L. Timulak
    • 2
  1. 1.Cinical Research & InnovationSilverCloud HealthDublinIreland
  2. 2.E-mental Health Research Group, School of PsychologyUniversity of Dublin, Trinity CollegeDublinIreland

Personalised recommendations