Internet-based cognitive therapy for depression : treatment efficacy and dropout

• Main Author: Ester María Ólafsdóttir 1988-
• Other Authors: Háskólinn í Reykjavík
• Format: Master Thesis
• Language: English
• Published: 2024
• Subjects: Klínísk sálfræði; Meistaraprófsritgerðir; Clinical psychology; Iceland
• Online Access: http://hdl.handle.net/1946/47722

Objectives: This study aims to evaluate the efficacy, dropout rates, and non-completion rates of internet-based cognitive therapy (iCBT) for depression in Iceland, as well as identify background variables associated with non-completion of therapy. Method: A single-group repeated measure design with Last Observation Carried Forward (LOCF) was employed. Pre- post data were analyzed from a 10-session iCBT program for depression at Mín Líðan, collected between May 2018 and February 2024. Data included background questions and Patient Health Questionnaire 9 (PHQ-9) at three time points. Dropout was defined as individuals who registered for the initial session but did not complete the first PHQ-9. Non- completers were those who completed the first but not the last PHQ-9, while completers were those who finished all three PHQ-9 assessments. A total of 1523 individuals registered for the treatment, with 253 participants completed the first PHQ-9 (60.5% female, 39.5% males). The mean age was 37.9 years (SD = 11.29). Statistical analysis included chi-square, logistic regression, ANOVA, pairwise comparison and t-test. Results: Of the 1523 registered individuals, 1270 (83.3%) dropped out. Among those who completed the first PHQ-9 assessment, 200 (79.1%) did not complete the therapy, while 53 (20.9%) successfully completed it. Education was significant predictor of therapy completion. ANOVA results showed a significant effect of time on PHQ-9 scores, with decrease over time. There was no difference in the first or second PHQ-9 assessments between completers and non-completers. Discussion: The high rates of dropout and non-completion are concerning and exceeded the those reported in previous research. While depression symptoms decreased throughout the treatment course, the absence of a control group prevents definitive attribution of these changes solely to the treatment. Given the widespread prevalence of depression and lengthy for appropriate treatments, further studies on this topic are recommended. Keywords: depression, ...