Could an Internet-delivered web platform — accessible from both mobile and desktop browsers — help those suffering from unipolar depression? Preliminary results with Hamburg, Germany-based web service Deprexis are promising.

We’ve previously covered how cell phones can help with depression, video games could help with anxiety, and how texting could help with adolescent depression. And, according to Meyer et al in a recent Internet Interventions clinical research article, 25 randomized controlled trials plus several systematic reviews and meta-analyses show that Internet modalities could help reduce depression symptoms, if well-designed.

Deprexis, a website for both patients and providers to use, acts like a Choose-Your-Own Adventure game with “simulated dialogues.” Patients can select different response options to dialogues with the system.

In this case, the dialogues are based on cognitive-behavioral techniques, including “cognitive restructuring, behavioral activation, problem-solving, and acceptance/mindfulness.” The web service also offers SMS messages, symptom-tracking, printable worksheets, and audio recordings.

More recently, at the American Psychiatric Association, research author Jan Philipp Klein of Lübeck University in Lübeck, Germany, presented on a study of 1,013 participants with mild to moderate depression, and measured depressive symptoms with the PHQ-9, clinician ratings, MINI interview, and the Hamilton Rating Scale for Depression.

Study participants were divided into two groups. One group received the intervention: in this case, 12 weeks of access to Deprexis. The control group — the treatment-as-usual group — did not receive Deprexis. Both groups were allowed to pursue pharmacotherapy or psychotherapy as they pleased.

According to study author Klein in a recent interview with Medscape editorial director Bret Stetka, MD, both groups showed a response, with the intervention group showing a larger improvement that sustained after three months. A similar study published in the aforementioned Internet Interventions article with more severe depression (with a PHQ-9 greater than 14), also showed similar results.

“There are patients who are skeptical and afraid of stigmatization and don’t want to go into the therapist’s office, or who might not have a therapist available, like in the Nevada desert,” Klein stated in an interview with Medscape, on how computerized mental health treatments could be a useful adjunct to traditional psychotherapy and clinic visits.
“It could be helpful in cases like this, as an easier-to-access alternative treatment, or it could be used temporarily while waiting for psychotherapy. This also could be beneficial for immigrants who may not speak the language well, which precludes psychotherapy. I think there will be a lot of uses for this.”