Sunday, November 19, 2017
Health

Depressed? Look for help from a human, not a computer

RECOMMENDED READING


Almost 8 percent of Americans 12 and older dealt with depression at some point between 2009 and 2012. With that many of us feeling blue, wouldn't it be nice if we could simply hop on the computer in our pajamas, without any of the stigma of asking for help, and find real relief?

Online programs to fight depression are already commercially available. And while they sound efficient and cost-saving, a study out of the U.K. reports that they're not effective, primarily because depressed patients aren't likely to engage with them or stick with them.

The study, which was published in The BMJ on Wednesday, looked at computer-assisted cognitive behavioral therapy and found that it was no more effective in treating depression than the usual care patients receive from a primary care doctor.

Traditional cognitive behavioral therapy (CBT) is considered an effective form of talk therapy for depression, helping people challenge negative thoughts and change the way they think in order to change their mood and behaviors. Online CBT programs have been gaining popularity, with the allure of providing low-cost help wherever someone has access to a computer.

A team of researchers from the University of York conducted a randomized controlled trial with 691 depressed patients from 83 physician practices across England. The patients were split into three groups: one group received only usual care from a physician while the other two groups received usual care from a physician plus one of two computerized CBT programs, either "Beating the Blues" or "MoodGYM." Participants were balanced across the three groups for age, sex, educational background, severity and duration of depression, and use of antidepressants.

After four months, the patients using the computerized CBT programs, or cCBT, had no improvement in depression levels over the patients who were only getting usual care from their doctors. "Uptake and use of cCBT was low, despite regular telephone support," the study authors wrote. Almost a quarter of participants dropped out within four months, and patients noted the "difficulty in repeatedly logging on to computer systems when they are clinically depressed."

"It's an important, cautionary note that we shouldn't get too carried away with the idea that a computer system can replace doctors and therapists," says Christopher Dowrick, a professor of primary medical care at the University of Liverpool, who wrote an accompanying editorial. "We do still need the human touch or the human interaction, particularly when people are depressed."

The lack of patient engagement in this study means these programs aren't the panacea that busy doctors and cost-conscious health care officials might be hoping for, Dowrick wrote in the editorial. Yet it's important to note that the study was conducted in a primary care setting, he says, because many other studies on cCBT that show some benefit have been conducted in psychological settings, where patients might be more motivated to engage with these kinds of online programs.

Despite the unenthusiastic findings of the study, Dowrick says that do-it-yourself treatments like cCBT can still be effective. But they're more likely to succeed when people have relatively mild symptoms of depression or are in a recovery stage — the participants in this study were mostly in the category of moderate to severe depression, he says. Computerized CBT is also more likely to succeed, he adds, if the patients are open to seeking help on a computer and when they have a "reasonable amount" of guidance as they go through the program, preferably from a therapist. In this study, he says, participants each totaled roughly six minutes of telephone support and guidance.

Being depressed can mean feeling "lost in your own little small, negative, dark world," Dowrick says. Having a person, instead of a computer, reach out to you is particularly important in combating that sense of isolation. "When you're emotionally vulnerable, you're even more in need of a caring human being," he says.

Comments
New shingles vaccine touted as a breakthrough for older adults

New shingles vaccine touted as a breakthrough for older adults

Medical researchers and government health policymakers, a cautious lot, normally take pains to keep expectations modest when they’re discussing some new finding or treatment.They warn about studies’ limitations. They point out what isn’t known. They ...
Published: 11/17/17
BayCare’s HealthHub breaks ground behind Valrico shopping center

BayCare’s HealthHub breaks ground behind Valrico shopping center

VALRICO — Health care officials broke ground Thursday on the long anticipated HealthHub at Bloomingdale, which will bring about 150 jobs to an area that’s experiencing tremendous growth and provide patients with the latest in technological care.A pro...
Updated: 5 hours ago
In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

Despite the budget cuts, the attempts to repeal and replace, and reports of sharp rises in premiums, Floridians and other Americans are signing up for health insurance under the Affordable Care Act at record rates this year.Enrollment has surged 47 p...
Published: 11/16/17
Updated: 11/17/17
Study: Mental quickness exercises can lower risk of dementia

Study: Mental quickness exercises can lower risk of dementia

Where did I leave my keys?As we age, it can take longer to answer a question like that.Humans begin to lose cognitive ability at age 25. Dementia, or the decline of memory most commonly seen in aging adults, takes hold early on and is gradual, but ac...
Published: 11/16/17
Blood pressure of 130 is the new ‘high,’ according to update of guidelines

Blood pressure of 130 is the new ‘high,’ according to update of guidelines

The nation’s heart experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of U.S. adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition earl...
Published: 11/13/17
Are Honey Nut Cheerios healthy? A look inside the box

Are Honey Nut Cheerios healthy? A look inside the box

I had a bowl of Honey Nut Cheerios recently. It had been awhile. Regular Cheerios are more my thing. But sometimes I finish my box faster than my kids do and find myself straying to their side of the cupboard.Honey Nut is America’s best-selling break...
Published: 11/11/17
Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

The corporate owner of Bayfront Health St. Petersburg could be facing a serious federal investigation related to its commitment to take care of St. Petersburg’s poorest residents.In its most recent filing with the U.S. Securities and Exchange Commiss...
Published: 11/09/17
Updated: 11/14/17
Learn to practice gratitude year-round, not just on Thanksgiving

Learn to practice gratitude year-round, not just on Thanksgiving

Is it part of your Thanksgiving tradition to go around the dinner table and have everyone share one thing they are thankful for? The exercise reminds us that the day is about more than just turkey and pie. And, for those who take it seriously, it for...
Published: 11/07/17
Updated: 11/10/17
When the goal is getting to the ER fast and cheap, some choose Uber over 911

When the goal is getting to the ER fast and cheap, some choose Uber over 911

Matt Lavin had just arrived in Charlottesville, Va., for a business trip when he started feeling sick. By the time he got to his hotel around 11 p.m., he felt excruciating pain. "I didn’t know what was happening, but I knew something wasnR...
Published: 11/06/17

Stunning study: Heart stents fail to ease chest pain

A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them, researchers reported Wednesday.Their study focused on the insertion of stents, tiny wire cages, to open blocked arteries. The dev...
Updated one month ago