Guided digital health intervention for depression in Lebanon: randomised trial

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Ressource 1Download: 2022 Cuijpers, EBMH, iCBT for depression in Lebanon.pdf (279.55 [Ko])
State: Public
Version: author
License: CC BY-NC 4.0
Serval ID
serval:BIB_C2F696A984A7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Guided digital health intervention for depression in Lebanon: randomised trial
Journal
Evidence Based Mental Health
Author(s)
Cuijpers P., Heim Eva, Abi Ramia J., Burchert S., Carswell K., Cornelisz I., Knaevelsrud C., Noun P., van Klaveren C., van't Hof E., Zoghbi E., van Ommeren M., ElChammay R.A.
ISSN
1362-0347
1468-960X
Publication state
Published
Issued date
16/05/2022
Language
english
Abstract
<jats:sec><jats:title>Background</jats:title><jats:p>Most people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>680 people with depression (PHQ-9&gt;10) and impaired functioning (WHODAS&gt;16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Guided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition.</jats:p></jats:sec><jats:sec><jats:title>Clinical implications</jats:title><jats:p>Guided digital mental health interventions should be considered for implementation in LMICs.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p>ClinicalTrials.gov <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT03720769">NCT03720769</jats:ext-link>.</jats:p></jats:sec>
Create date
20/06/2022 8:07
Last modification date
21/06/2022 6:12
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