An individualized proactive e-health intervention promoting a lifestyle against depression: Results of a randomized controlled trial over 24 months

Purpose We developed a fully automated e-health intervention promoting a depression-preventive lifestyle. Here, we present preliminary results from a proof-of-concept study among non-treatment seekers.

Methods German medical care patients were systematically screened. Eligible participants with at least one past year subsyndromal depressive episode and giving informed consent (participation rate 49%; n = 456, mean age = 41 years, 63% females) were randomized into an assessment only control (CG) or an intervention group (IG). Over 6 months, IG received 3 feedback letters and weekly text messages promoting depression preventive behaviors (DPBs): dealing with unhelpful thoughts, stress management, exercising, help-seeking, behavioral activation. Generalized estimation equation analyses adjusting for gender, age, education, site and setting were used to analyze changes in the number of applied DPBs, well-being (WHO-5) and depressive symptoms (PHQ-8), after 6 (n = 335), 12 (n = 338) and 24-months (n = 281, preliminary results).

Results Over time, applied DPBs and well-being increased, while depressive symptoms decreased in both groups. Increases in the applied DPBs were larger in IG compared to CG at month 6 (p = 0.002). At month 12 and 24, this effect vanished (p = 0.084; p = 0.061). Increases in well-being were larger in the IG compared to CG only at month 12 (p = 0.049; no difference at month 6; not assessed at month 24). Decreases in depressive symptoms did not differ across groups at month 6 and 24 (p = 0.318; p = 0.943), however at month 12 decreases were smaller in IG compared to the CG (p = 0.013).

Conclusions Our intervention effectively fostered DPB uptake and well-being, while no beneficial effects on depressive symptoms were observed. Intervention effects on DPBs were not persistent, which is a common problem in lifestyle interventions.

Publikationsverlauf

Artikel online veröffentlicht:
02. September 2021