Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis
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Other documents of the author: Karyotaki, Eirini; Kemmeren, Lise; Riper, Heleen; Twisk, Jos; Hoogendoorn, Adriaan; Kleiboer, Annet; Mira, Adriana; Mackinnon, Andrew; Meyer, Björn; Botella, Cristina; Littlewood, Elizabeth; Andersson, Gerhard; Christensen, Helen; Klein, Jan P.; Schröder, Johanna; Bretón-López, Juana; Scheider, Justine; Griffiths, Kathy; Farrer, Louise; Huibers, Marcus J. H.; Phillips, Rachel; Gilbody, Simon; Moritz, Steffen; Berger, Thomas; Pop, Victor; Spek, Viola; Cuijpers, Pim
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comunitat-uji-handle2:10234/8033
comunitat-uji-handle3:10234/8636
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Title
Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysisAuthor (s)
Date
2018Publisher
Cambridge University PressISSN
0033-2917; 1469-8978Bibliographic citation
Karyotaki E et al (2018). Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. Psychological Medicine 48, 2456–2466. https:// doi.org/10.1017/S0033291718000648Type
info:eu-repo/semantics/articlePublisher version
https://www.cambridge.org/core/journals/psychological-medicine/article/is-selfgu ...Version
info:eu-repo/semantics/publishedVersionSubject
Abstract
Background. Little is known about potential harmful effects as a consequence of self-guided
internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates.
Thus, safety concerns remain and ... [+]
Background. Little is known about potential harmful effects as a consequence of self-guided
internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates.
Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical
practice. We aimed to conduct an individual participant data (IPD) meta-analysis to
determine the prevalence of clinically significant deterioration (symptom worsening) in adults
with depressive symptoms who received self-guided iCBT compared with control conditions.
Several socio-demographic, clinical and study-level variables were tested as potential moderators
of deterioration.
Methods. Randomised controlled trials that reported results of self-guided iCBT compared
with control conditions in adults with symptoms of depression were selected. Mixed effects
models with participants nested within studies were used to examine possible clinically significant
deterioration rates.
Results. Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of
the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and
9.1% of participants in the intervention and control groups, respectively). Participants in
self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control
conditions. None of the examined participant- and study-level moderators were significantly
associated with deterioration rates.
Conclusions. Self-guided iCBT has a lower rate of negative outcomes on symptoms than control
conditions and could be a first step treatment approach for adult depression as well as an
alternative to watchful waiting in general practice. [-]
Is part of
Psychological Medicine, Volume 48, Issue 15, 2018Investigation project
grant 603098 for the E-COMPARED projectRights
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