Computerized cognitive behaviour therapy for depression in people with a chronic physical illness

Abstract

Purpose Computerized cognitive behaviour therapy ( cCBT ) is becoming an increasingly well‐recognized therapeutic option for the treatment of depression. With acknowledged high prevalence of depression within chronic physical ill‐health populations and a need to increase access to psychological therapies, cCBT represents a low‐intensity intervention with the potential to have great utility within health care settings. Methods This article systematically reviews the evidence for the effectiveness of cCBT for the treatment of depression with people who have a chronic physical health problem. A comprehensive search was conducted to identify relevant randomized, controlled trials. Identified studies were quality‐assessed, and data were extracted by two reviewers. Results One study investigating cCBT for the treatment of depression in people with diabetes fulfilled inclusion criteria. The trial reported positive outcomes compared to a waiting‐list control condition. Conclusions The available literature suggests cCBT programmes may be beneficial for populations with a chronic physical illness experiencing depression. This conclusion is based on the findings of a single study, which involved the evaluation of a cCBT package by its developers, included a short follow‐up and featured specialist health care support. Additionally, the study reported considerable attrition suggesting the intervention might not have been acceptable to many participants. It is likely that cCBT may be a way in which to increase access to psychological therapies. However, prior to any definitive conclusions being made, further high‐quality research to establish the acceptability, feasibility, efficacy, and effectiveness of cCBT for specific chronic physical health conditions is required. Statement of contribution What is already known on this subject? Computerized cognitive behaviour therapy (cCBT) is increasingly being utilized as a low‐intensity treatment for depression within general adult populations following positive randomized, controlled trials of both commercial and free‐to‐use programmes. There is potential application for such programmes in addressing the high prevalence of depression within physically ill populations. However, to date, there has been no attempt to review the literature regarding the application of cCBT to treat depression in people with a chronic physical illness. What does this study add? Fifty‐six studies were identified and screened for inclusion in the present systematic review. One RCT, applying cCBT to a diabetes population, fulfilled inclusion criteria. Development of complex interventions should be guided by a recognized flexible, phased framework.

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