The effectiveness of an online e-health application compared to attention placebo or Sertraline in the treatment of Generalised Anxiety Disorder

Helen Christensen, Andrew J. Mackinnon, Philip J. Batterham, Bridianne O'Dea, Adam J. Guastella, Kathleen M. Griffiths, Claire Eagleson, Kanupriya Kalia Hehir, Justin Kenardy, Kylie Bennett, Ian Hickie
2014 Internet Interventions  
Generalised Anxiety Disorder (GAD) is a high prevalence, chronic disorder that can be treated effectively through a number of web-based programs. However, online web programs for GAD have not been compared to standard pharmacological treatment. The present study compares an Internet Intervention (Active Website) for GAD and a selective serotonin re-uptake inhibitor (SSRI) (Sertraline), with an online attention placebo condition (Control Website). Objective: To evaluate the effectiveness of a
more » ... fectiveness of a web-based intervention for GAD in comparison to standard antidepressant medication and an online attention placebo condition over a 10 week period, and with a follow-up at 6 and at 12 months. Methods: The study was part of a larger scale prevention program. 152 people aged 18-30 years who met the criteria for GAD on the MINI received referrals to the treatment sub-study. The primary outcome was anxiety symptoms measured by the Generalised Anxiety Disorder 7-item Scale (GAD-7), and the secondary outcome was depression measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results: There was very poor uptake to the trial (around 14% of those referred). However, even in this small sample, Sertraline compared to the Control Website was significant at post-test and 6 months, and the Internet Intervention was significant at post-test. Relative to the Control Website condition at post-test, for the GAD-7 and CES-D respectively, the between group effect sizes were d = 2.43 and d = 0.68 for the Active Website condition, and 3.00 and 0.20 for the Sertraline condition. The within group effect size for the Control Website from baseline to post-test was −0.04 for the GAD-7 and 0.31 for CES-D respectively. Conclusions: The findings will need to be extended and confirmed in a larger trial. However, they do suggest that both standard pharmacological treatment and online interventions for GAD are effective in samples with a diagnosis of GAD recruited via online methods. The low rate of engagement for face-to-face treatment by those who opt first for a web program suggests that treatment preferences are important in help-seeking.
doi:10.1016/j.invent.2014.08.002 fatcat:x6z5cxfu6rffbita36lu2eemam