HealthDay News — For patients with depression and anxiety, online computerized cognitive behavioral therapy (CCBT) provided via a collaborative care program is beneficial, but combining an internet support group (ISG) with CCBT offers no additional benefit, according to a study published online Nov. 8 in JAMA Psychiatry.

Bruce L. Rollman, MD, MPH, from the University of Pittsburgh School of Medicine in Pittsburgh, and colleagues conducted a three-arm randomized trial in which primary care physicians from 26 practices referred 2,884 patients (aged 18 to 75 years) in response to an electronic medical record prompt. Seven-hundred four patients were eligible and randomized to CCBT alone (301 patients), CCBT+ISG (302 patients), or usual care (101 patients). A total of 604 patients completed the primary outcome assessment at six months.

The researchers found that similar six-month improvements were reported in mental health-related quality of life, mood, and anxiety symptoms for patients receiving CCBT+ISG compared with patients receiving CCBT alone. Patients in the CCBT-alone cohort reported significant six-month effect size improvements in mood and anxiety compared with patients receiving usual care (effect size, 0.31 and 0.26, respectively); these improvements persisted six months later. Completing more CCBT sessions was correlated with greater effect size improvements in mental health-related quality of life and symptoms.

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“While providing moderated access to an ISG provided no additional benefit over guided CCBT at improving mental health-related quality of life, mood, and anxiety symptoms, guided CCBT alone is more effective than usual care for these conditions,” the authors write.

One author disclosed ties to the pharmaceutical industry.


Rollman BL,  Belnap BH,  Abebe KZ, et al. Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care: a randomized clinical trial [published online November 08, 2017]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.3379