Multimodal e-mental health treatment for depression: A feasibility trial

Background: internet interventions for depression have shown less than optimal adherence. this study describes the feasibility trial of a multimodal e-mental health intervention designed to enhance adherence and outcomes for depression. the intervention required frequent brief log-ins for self-monitoring and feedback as well as email and brief telephone support guided by a theory-driven manualized protocol. objective: the objective of this feasibility trial was to examine if our internet intervention plus manualized telephone support program would result in increased adherence rates and improvement in depression outcomes. methods: this was a single arm feasibility trial of a 7-week intervention. results: of the 21 patients enrolled,2 (9.5%) dropped out of treatment. patients logged in 23.2 ± 12.2 times over the 7 weeks. significant reductions in depression were found on all measures,including the patient health questionnaire depression scale (phq-8) (cohen's d = 1.96,p <.001),the hamilton rating scale for depression (d = 1.34,p <.001),and diagnosis of major depressive episode (p <.001). conclusions: the attrition rate was far lower than seen either in internet studies or trials of face-to-face interventions,and depression outcomes were substantial. these findings support the feasibility of providing a multimodal e-mental health treatment to patients with depression. although it is premature to make any firm conclusions based on these data,they do support the initiation of a randomized controlled trial examining the independent and joint effects of internet and telephone administered treatments for depression.