Evidence map›Paper›PMID 38351099›Full record

ArticleBMJ mental health2024

Are web-based stress management interventions effective as an indirect treatment for depression? An individual participant data meta-analysis of six randomised trials.

Mathias Harrer, Patricia Nixon, Antonia A Sprenger, Elena Heber, Leif Boß, Hanna Heckendorf, Claudia Buntrock, David Daniel Ebert, Dirk Lehr

Open access · diamondAbstract readNetwork Meta-Analysis
In one paragraph

Article in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Mathias Harrer *Technical University of Munich, Munich, Germany.ORCID http://orcid.org/0000-0001-7016-2687
Patricia Nixon *Health Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany.ORCID http://orcid.org/0000-0002-9747-3845
Antonia A SprengerOtto-von-Guericke-Universitat Magdeburg, Magdeburg, Germany.ORCID http://orcid.org/0000-0002-1180-7702
Elena HeberGetOn Institut für Gesundheitstrainings GmbH/HelloBetter, Hamburg, Germany.ORCID http://orcid.org/0000-0002-3438-0756
Leif BoßHealth Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany.ORCID http://orcid.org/0000-0001-9012-0839
Hanna HeckendorfHealth Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany.ORCID http://orcid.org/0000-0002-8665-0439
Claudia BuntrockOtto-von-Guericke-Universitat Magdeburg, Magdeburg, Germany.ORCID http://orcid.org/0000-0002-4974-5455
David Daniel EbertTechnical University of Munich, Munich, Germany.ORCID http://orcid.org/0000-0001-6820-0146
Dirk LehrHealth Psychology and Applied Biological Psychology, Leuphana Universitat Luneburg, Luneburg, Germany lehr@leuphana.de.ORCID http://orcid.org/0000-0002-5560-3605
Leuphana University of Lüneburg · DEOtto-von-Guericke-Universität Magdeburg · DEFriedrich-Alexander-Universität Erlangen-Nürnberg · DETechnical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

questionDepression is highly prevalent and associated with numerous adverse consequences for both individuals and society. Due to low uptake of direct treatment, interventions that target related, but less stigmatising problems, such as perceived stress, have emerged as a new research paradigm.This individual participant data (IPD) meta-analysis examines if a web-based stress management intervention can be used as an 'indirect' treatment of depression. STUDY SELECTION AND ANALYSIS: Bayesian one-stage models were used to estimate pooled effects on depressive symptom severity, minimally important improvement and reliable deterioration. The dose-response relationship was examined using multilevel additive models, and IPD network meta-analysis was employed to estimate the effect of guidance.

findingsIn total, N=1235 patients suffering from clinical-level depression from K=6 randomised trials were included. Moderate-to-large effects were found on depressive symptom severity at 7 weeks post-intervention (d=-0.65; 95% credibility interval (CrI): -0.84 to -0.48) as measured with the Center for Epidemiological Studies' Depression Scale. Effects were sustained at 3-month follow-up (d=-0.74; 95% CrI: -1.01 to -0.48). Post-intervention symptom severity was linearly related to the number of completed sessions. The incremental impact of guidance was estimated at d=-0.25 (95% CrI: -1.30 to 0.82), with a 35% posterior probability that guided and unguided formats produce equivalent effects.

conclusionsOur results indicate that web-based stress management can serve as an indirect treatment, yielding effects comparable with direct interventions for depression. Further research is needed to determine if such formats can indeed increase the utilisation of evidence-based treatment, and to corroborate the favourable effects for human guidance. STUDY REGISTRATION: Open material repository: osf.io/dbjc8, osf.io/3qtbe. TRIAL REGISTRATION NUMBER: German Clinical Trial Registration (DRKS): DRKS00004749, DRKS00005112, DRKS00005384, DRKS00005687, DRKS00005699, DRKS00005990.

Indexed as

DepressionPsychotherapyAnxietyBayes TheoremHumansInternetRandomized Controlled Trials as TopicAdult psychiatryDepression & mood disorders

Identifiers

PMID38351099
PMCPMC10897957
OpenAlexW4391826006

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.