Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders ina primary care population: A randomized controlled trial

Behaviour Research and Therapy

Volumn 59, Issue , 2014, Pages 1-11

  Nordgren, Lise Bergman ^a   Hedman, Erik ^b   Etienne, Julie ^a   Bodin, Jessica ^a   Kadowaki, Åsa ^c   Eriksson, Stina ^d   Lindkvist, Emelie ^d   Andersson, Gerhard ^a,b   Carlbring, Per ^e  

^a LINKÖPING UNIVERSITY   (Sweden)

^b KAROLINSKA INSTITUTE   (Sweden)

^c Operations and Specialty Surgery Center   (Sweden)

^d UMEÅ UNIVERSITY   (Sweden)

^e STOCKHOLM UNIVERSITY   (Sweden)

Author keywords

Anxiety; Cognitive behavior therapy; Comorbidity; Cost effectiveness; Depression; Internet delivered cognitive behavior therapy; Primary care

Indexed keywords

ADULT; ANXIETY DISORDER; ARTICLE; CLINICAL EFFECTIVENESS; COGNITIVE THERAPY; COMORBIDITY; CONTROLLED STUDY; COST BENEFIT ANALYSIS; COST CONTROL; COST EFFECTIVENESS ANALYSIS; COST UTILITY ANALYSIS; DEPRESSION; FEMALE; HUMAN; INTERNET; MAJOR CLINICAL STUDY; MALE; MOOD DISORDER; PRIMARY MEDICAL CARE; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL; TREATMENT DURATION; TREATMENT FAILURE; TREATMENT RESPONSE; AGED; ANXIETY DISORDERS; COMPUTER ASSISTED THERAPY; ECONOMICS; HEALTH CARE COST; MIDDLE AGED; PATIENT COMPLIANCE; PRIMARY HEALTH CARE; TREATMENT OUTCOME; YOUNG ADULT;

ADULT; AGED; ANXIETY DISORDERS; COGNITIVE THERAPY; COST-BENEFIT ANALYSIS; HEALTH CARE COSTS; HUMANS; INTERNET; MALE; MIDDLE AGED; PATIENT COMPLIANCE; PRIMARY HEALTH CARE; QUALITY OF LIFE; THERAPY, COMPUTER-ASSISTED; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84902258580     PISSN: 00057967     EISSN: 1873622X     Source Type: Journal    
DOI: 10.1016/j.brat.2014.05.007     Document Type: Article

References (80)

1. Almlöv J., Carlbring P., Källqvist K., Paxling B., Cuijpers P., Andersson G. Therapist effects in guided internet-delivered CBT for anxiety disorders. Behavioural and Cognitive Psychotherapy 2011, 39(03):311-322. 10.1017/S135246581000069X.
2. Alonso J., Angermeyer M.C., Bernert S., Bruffaerts R., Brugha T.S., Bryson H. 12-Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. Supplementum 2004, 109(420):28-37. EsemeD/Mhedea Investigators, E. S. o. t. E. o. M. D. P. 10.1111/j.1600-0047.2004.00328.x.
3. Alonso J., Angermeyer M.C., Bernert S., Bruffaerts R., Brugha T.S., Bryson H. Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. Supplementum 2004, 109(420):21-27. EsemeD/Mhedea Investigators, E. S. o. t. E. o. M. D. P. 10.1111/j.1600-0047.2004.00327.x.
4. American Psychiatric Association Diagnostic and statistical manual of mental disorders 2000, American Psychiatric Press, Washington, DC. 4th ed., text revision ed.
5. Andersson G. Using the Internet to provide cognitive behaviour therapy. Behaviour Research and Therapy 2009, 47(3):175-180. 10.1016/j.brat.2009.01.010.
6. Andersson E., Ljótsson B., Smit F., Paxling B., Hedman E., Lindefors N., et al. Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial. BMC Public Health 2011, 11:215.
7. Andersson G., Carlbring P., Berger T., Almlöv J., Cuijpers P. What makes internet therapy work?. Cognitive Behaviour Therapy 2009, 38(SUPPL.1):55-60.
8. Andersson G., Carlbring P., Holmstrom A., Sparthan E., Furmark T., Nilsson-Ihrfelt E., et al. Internet-based self-help with therapist feedback and invivo group exposure for social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology 2006, 74(4):677-686. 10.1037/0022-006X.74.4.677.
9. Andrews G., Cuijpers P., Craske M.G., McEvoy P., Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS ONE 2010, 5(10):e13196. 10.1371/journal.pone.0013196.
10. Barkham M., Margison F., Leach C., Lucock M., Mellor-Clark J., Evans C., et al. Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology 2001, 69(2):184-196.
11. Barlow D.H., Allen L.B., Choate M.L. Toward a unified treatment for emotional disorders. Behavior Therapy 2004, 35(2):205-230.
12. Beck A.T., Epstein N., Brown G., Steer R.A. An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 1988, 56(6):893-897. 10.1037/0022-006X.56.6.893.
13. Bell C.J., Colhoun H.C., Carter F.A., Frampton C.M. Effectiveness of computerised cognitive behaviour therapy for anxiety disorders in secondary care. Australian and New Zealand Journal of Psychiatry 2012, 46(7):630-640. 10.1177/0004867412437345.
14. Bergström J., Andersson G., Ljótsson B., Rück C., Andréewitch S., Karlsson A., et al. Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial. BMC Psychiatry 2010, 10:54. 10.1186/1471-244X-10-54.
15. Bravo Vergel Y., Sculpher M. Quality-adjusted life years. Practical Neurology 2008, 8(3):175-182. 10.1136/pn.2007.140186.
16. Brown T.A., Campbell L.A., Lehman C.L., Grisham J.R., Mancill R.B. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology 2001, 110(4):585-599. 10.1037/0021-843x.110.4.585.
17. Carlbring P., Andersson G. Internet and psychological treatment. How well can they be combined?. Computers in Human Behavior 2006, 22:545-553.
18. Carlbring P., Bohman S., Brunt S., Buhrman M., Westling B.E., Ekselius L., et al. Remote treatment of panic disorder: a randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. American Journal of Psychiatry 2006, 163(12):2119-2125. 10.1176/appi.ajp.163.12.2119.
19. Carlbring P., Brunt S., Bohman S., Austin D., Richards J., Ost L.G., et al. Internet vs. paper and pencil administration of questionnaires commonly used in panic/agoraphobia research. Computers in Human Behavior 2007, 23(3):1421-1434. 10.1016/j.chb.2005.05.002.
20. Carlbring P., Maurin L., Törngren C., Linna E., Eriksson T., Sparthan E., et al. Individually-tailored, Internet-based treatment for anxiety disorders: a randomized controlled trial. Behaviour Research and Therapy 2011, 49(1):18-24. 10.1016/j.brat.2010.10.002.
21. Carlbring P., Nilsson-Ihrfelt E., Waara J., Kollenstam C., Buhrman M., Kaldo V., et al. Treatment of panic disorder: live therapy vs. self-help via the Internet. Behaviour Research and Therapy 2005, 43(10):1321-1333. 10.1016/j.brat.2004.10.002.
22. Carlbring P., Nordgren L.B., Furmark T., Andersson G. Long-term outcome of Internet-delivered cognitive-behavioural therapy for social phobia: a 30-month follow-up. Behaviour Research and Therapy 2009, 47(10):848-850. 10.1016/j.brat.2009.06.012.
23. Cohen J. Statistical power analysis for the behavioral sciences 1988, Lawrence Erlbaum Associates, Hillsdale, NJ, USA. 2nd ed.
24. Craske M.G. Transdiagnostic treatment for anxiety and depression. Depression and Anxiety 2012, 29(9):749-753.
25. Cuijpers P., Marks I.M., van Straten A., Cavanagh K., Gega L., Andersson G. Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cognitive Behaviour Therapy 2009, 38(2):66-82. 10.1080/16506070802694776.
26. Dear B.F., Titov N., Schwencke G., Andrews G., Johnston L., Craske M.G., et al. An open trial of a brief transdiagnostic internet treatment for anxiety and depression. Behaviour Research and Therapy 2011, 49(12):830-837. 10.1016/j.brat.2011.09.007.
27. Denollet J., Maas K., Knottnerus A., Keyzer J.J., Pop V.J. Anxiety predicted premature all-cause and cardiovascular death in a 10-year follow-up of middle-aged women. [Research Support, Non-U.S. Gov't]. Journal of Clinical Epidemiology 2009, 62(4):452-456.
28. Drummond M.F., Sculpher M.J., Torrence G.W., O'Brien B.J., Stoddart G.L. Methods for the evaluation of health care programmes 2005, Oxford University Press, Oxford.
29. Dolan P. Modeling valuations for EuroQol health states. Medical Care 1997, 35(11):1095-1108.
30. Eaton W.W., Neufeld K., Chen L.-S., Cai G. Acomparison of self-report and clinical diagnostic interviews for depression. Archives of General Psychiatry 2000, 57:217-222.
31. Efron B., Tibshirani R.J. An introduction to the bootstrap 1993, Chapman & Hall, New York.
32. Elfstrom M.L., Evans C., Lundgren J., Johansson B., Hakeberg M., Carlsson S.G. Validation of the Swedish version of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). Clinical Psychology & Psychotheraphy 2012, 10.1002/cpp.1788.
33. EuroQol-Group EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990, 16(3):199-208.
34. First M.B., Gibbon M., Spitzer R.L., Williams J.B.W. Structured clinical interview for DSM-IV Axis I Disorders (SCID-I) 1997, American Psychiatric Press, Washington, D.C.
35. Frisch M.B., Cornell J., Villanueva M., Retzlaff P.J. Clinical validation of the Quality of Life Inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment 1992, 4(1):92-101.
36. Gerhards S.A., de Graaf L.E., Jacobs L.E., Severens J.L., Huibers M.J., Arntz A., et al. Economic evaluation of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial. Brittish Journal of Psychiatry 2010, 196:310-318.
37. Gueorguieva R., Krystal J.H. Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Archives of General Psychiatry 2004, 61(3):310-317. 10.1001/archpsyc.61.3.310.
38. Hakkaart-Van Roijen L., Van Straten A., Donker M. Manual:Trimbos/iMTA Questionnaire for costs associated with psychiatric illness 2002, Erasmus University, Rotterdam.
39. Hedman E., Andersson E., Ljótsson B., Andersson G., Rück C., Lindefors N. Cost-effectiveness of Internet-based cognitive behavior therapy vs. cognitive behavioral group therapy for social anxiety disorder: results from a randomized controlled trial. Behaviour Research and Therapy 2011, 49(11):729-736.
40. Hedman E., Andersson G., Ljótsson B., Andersson E., Rück C., Mörtberg E., et al. Internet-based cognitive behavior therapy vs. Cognitive behavioral group therapy for social anxiety disorder: a randomized controlled non-inferiority trial. PLoS ONE 2011, 6(3):e18001. 10.1371/journal.pone.0018001.
41. Hedman E., Furmark T., Carlbring P., Ljótsson B., Rück C., Lindefors N., et al. A5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder. Journal of Medical Internet Research 2011, 13(2):e39. 10.2196/jmir.1776.
42. Hedman E., Ljótsson B., Lindefors N. Cognitive behavior therapy via the Internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Review of Pharmacoeconomics and Outcomes Research 2012, 12(6):745-764.
43. Hedman E., Ljótsson B., Rück C., Bergstrom J., Andersson G., Kaldo V., et al. Effectiveness of Internet-based cognitive behaviour therapy for panic disorder in routine psychiatric care. Acta Psychiatrica Scandinavica 2013, 10.1111/acps.12079.
44. Hedman E., Ljótsson B., Rück C., Furmark T., Carlbring P., Lindefors N., et al. Internet administration of self-report measures commonly used in research on social anxiety disorder: a psychometric evaluation. Computers in Human Behavior 2010, 26(4):736-740. 10.1016/j.chb.2010.01.010.
45. Hoifodt R.S., Strom C., Kolstrup N., Eisemann M., Waterloo K. Effectiveness of cognitive behavioural therapy in primary health care: a review. Family Practice 2011, 28(5):489-504. 10.1093/fampra/cmr017.
46. Jacobson N.S., Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 1991, 59(1):12-19.
47. Johansson R., Sjoberg E., Sjogren M., Johnsson E., Carlbring P., Andersson T., et al. Tailored vs. standardized internet-based cognitive behavior therapy for depression and comorbid symptoms: a randomized controlled trial. PLoS ONE 2012, 7(5):e36905.
48. Kiropoulos L.A., Klein B., Austin D.W., Gilson K., Pier C., Mitchell J., et al. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?. Journal of Anxiety Disorders 2008, 22(8):1273-1284.
49. Kraemer H.C., Wilson G.T., Fairburn C.G., Agras W.S. Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry 2002, 59:877-883.
50. Lindner P., Andersson G., Öst L.-G., Carlbring P. Validation of the Internet-administered Quality of Life Inventory (QOLI) in different psychiatric conditions. Cognitive Behaviour Therapy 2013, 42:315-327.
51. Mattila-Evenden M., Svanborg P., Gustavsson P., Åsberg M. Determinants of self-rating and expert rating concordance in psychiatric out-patients, using the affective subscales of the CPRS. Acta Psychiatrica Scandinavica 1996, 94(6):386-396.
52. Mendlowicz M.V., Stein M.B. Quality of life in individuals with anxiety disorders. American Journal of Psychiatry 2000, 157(5):669-682.
53. Mewton L., Wong N., Andrews G. The effectiveness of internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice. Depression and Anxiety 2012, 10.1002/da.21995.
54. Nordgren L.B., Andersson G., Kadowaki A., Carlbring P. Tailored internet-administered treatment of anxiety disorders for primary care patients: study protocol for a randomised controlled trial. Trials 2012, 13:16. 10.1186/1745-6215-13-16.
55. Olatunji B.O., Cisler J.M., Tolin D.F. Quality of life in the anxiety disorders: a meta-analytic review. Clinical Psychology Review 2007, 27(5):572-581. http://dx.doi.org/10.1016/j.cpr.2007.01.015.
56. Patterson W.M., Dohn H.H., Bird J., Patterson G.A. Evaluation of suicidal patients: the SAD PERSONS scale. Psychosomatics 1983, 24(4). 343-345, 348-349. 10.1016/S0033-3182(83)73213-5.
57. Paxling B., Almlov J., Dahlin M., Carlbring P., Breitholtz E., Eriksson T., et al. Guided internet-delivered cognitive behavior therapy for generalized anxiety disorder: a randomized controlled trial. Cognitive Behaviour Therapy 2011, 40(3):159-173. 10.1080/16506073.2011.576699.
58. Rabin R., Charro F.d EQ-SD: a measure of health status from the EuroQol Group. Annals of Medicine 2001, 33(5):337-343. 10.3109/07853890109002087.
59. Ravens-Sieberer U., Wille N., Badia X., Bonsel G., Burström K., Cavrini G., et al. Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Quality of Life Research 2010, 19(6):887-897. 10.1007/s11136-010-9649-x.
60. Reger M.A., Gahm G.A. Ameta-analysis of the effects of internet- and computer-based cognitive-behavioral treatments for anxiety. Journal of Clinical Psychology 2009, 65(1):53-75. 10.1002/jclp.20536.
61. Rohde P., Lewinsohn P.M., Seeley J.R. Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. American Journal of Psychiatry 1997, 154(11):1593-1598.
62. Roy-Byrne P., Craske M.G., Sullivan G., Rose R.D., Edlund M.J., Lang A.J., et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA 2010, 303(19):1921-1928. 10.1001/jama.2010.608.
63. Ruwaard J., Lange A., Schrieken B., Dolan C.V., Emmelkamp P. The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS ONE 2012, 7(7):e40089. 10.1371/journal.pone.0040089.
64. Salim A., Mackinnon A., Christensen H., Griffiths K. Comparison of data analysis strategies for intent-to-treat analysis in pre-test-post-test designs with substantial dropout rates. Psychiatry Research 2008, 160(3):335-345.
65. Shadish W.R., Matt G.E., Navarro A.M., Phillips G. The effects of psychological therapies under clinically representative conditions: a meta-analysis. Psychological Bulletin 2000, 126(4):512-529.
66. Shadish W.R., Navarro A.M., Crits-Christoph P., Jorm A.F., Nietzel M.T., Robinson L., et al. Evidence that therapy works in clinically representative conditions. Journal of Consulting and Clinical Psychology 1997, 65(3):355-365.
67. Silfvernagel K., Carlbring P., Kabo J., Edstrom S., Eriksson J., Manson L., et al. Individually tailored internet-based treatment for young adults and adults with panic attacks: randomized controlled trial. Journal of Medical Internet Research 2012, 14(3):e65.
68. Smit F., Cuijpers P., Oostenbrink J., Batelaan N., de Graaf R., Beekman A. Costs of nine common mental disorders: implications for curative and preventive psychiatry. Journal of Mental Health Policy and Economics 2006, 9(4):193-200.
69. Snaith R.P., Harrop F.M., Newby D.A., Teale C. Grade scores of the Montgomery-Asberg depression and the clinical anxiety scales. British Journal of Psychiatry 1986, 148(MAY):599-601.
70. Spek V., Cuijpers P., Nyklicek I., Riper H., Keyzer J., Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 2007, 37(3):319-328. 10.1017/S0033291706008944.
71. Stein M.B., Sherbourne C.D., Craske M.G., Means-Christensen A., Bystritsky A., Katon W., et al. Quality of care for primary care patients with anxiety disorders. American Journal of Psychiatry 2004, 161(12):2230-2237. 10.1176/appi.ajp.161.12.2230.
72. Svanborg P., Åsberg M. Anew self-rating scale for depression and anxiety states based on the Comprehensive Psychopathological Rating Scale. Acta Psychiatrica Scandinavica 1994, 89(1):21-28.
73. Titov N., Andrews G., Johnston L., Robinson E., Spence J. Transdiagnostic Internet treatment for anxiety disorders: a randomized controlled trial. Behaviour Research and Therapy 2010, 48(9):890-899.
74. Titov N., Dear B.F., Schwencke G., Andrews G., Johnston L., Craske M.G., et al. Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behaviour Research and Therapy 2011, 49(8):441-452.
75. Titov N., Gibson M., Andrews G., McEvoy P. Internet treatment for social phobia reduces comorbidity. Australian and New Zealand Journal of Psychiatry 2009, 43(8):754-759. 10.1080/00048670903001992.
76. Vernmark K., Lenndin J., Bjarehed J., Carlsson M., Karlsson J., Oberg J., et al. Internet administered guided self-help versus individualized e-mail therapy: a randomized trial of two versions of CBT for major depression. Behaviour Research and Therapy 2010, 48(5):368-376. 10.1016/j.brat.2010.01.005.
77. Warmerdam L., Smit F., van Straten A., Riper H., Cuijpers P. Cost-utility and cost-effectiveness of internet-based treatment for adults with depressive symptoms: randomized trial. Journal of Medical and Internet Research 2010, 12:e53.
78. Weisberg R.B., Dyck I., Culpepper L., Keller M.B. Psychiatric treatment in primary care patients with anxiety disorders: a comparison of care received from primary care providers and psychiatrists. American Journal of Psychiatry 2007, 164(2):276-282. 10.1176/appi.ajp.164.2.276.
79. Wittchen H.U., Jacobi F. Size and burden of mental disorders in Europe-a critical review and appraisal of 27 studies. European Neuropsychopharmacology 2005, 15(4):357-376. 10.1016/j.euroneuro.2005.04.012.
80. Wittchen H.U., Jacobi F., Rehm J., Gustavsson A., Svensson M., Jonsson B., et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology 2011, 21(9):655-679. 10.1016/j.euroneuro.2011.07.018.