Published: 13-01-2014 00:00 | Updated: 29-10-2014 10:03

Online CBT effective treatment for depression

Cognitive behaviour therapy (CBT) over the internet has been proven to be an effective treatment for depression in a large clinical study conducted at Karolinska Institutet. The study, which is published in the scientific journal Journal of Affective Disorders, is one of the first to look at the treatment when it is given in a conventional care context.

CBT is an effective treatment for depression, but access to the treatment is limited. One way to increase accessibility is to provide it via the internet. In internet-based CBT, the patients reads extensive texts and carry out exercises on their own while keeping in contact with a psychologist via a secure system, similar to e-mail.

The new clinical study at Karolinska Institutet has monitored around 1,200 patients who have received internet-based CBT for depression at the Internet Psychiatry Unit, Psychiatric Clinic Southwest at Karolinska University Hospital Huddinge. The researchers found that the treatment was effective in reducing depressive symptoms and sleep difficulties.

"The results of the study confirm that we now have a psychological treatment for depression that is highly effective and also available", says Erik Hedman at the Department of Clinical Neuroscience, first author of the study. "Internet CBT has a high level of accessibility, which means that many people suffering from depression have the opportunity to receive treatment that is brief, offered under the regular county council health service and produces good results."

A number of previous studies have shown that online CBT has proven effective against depression. The study in question is one of the first in the world conducted in a conventional care context and the effect of the treatment was comparable to the effects shown in previously published randomised trials.

"The patients that are suitable for normal CBT are usually suitable for internet-based CBT", says Erik Hedman. "An important advantage of the online treatment is that each individual psychologist can treat more people in the same time frame and that those receiving the treatment are not restricted by set meeting times but can work on the treatment in their own time. The disadvantage is that online CBT requires patients to be fluent in written and spoken Swedish."

Around a sixth of the population will at some point in their life suffer from depression. The illness causes great suffering and is linked to reduced quality of life, sleeping disorders and increased risk of suicidal tendencies. Online CBT is currently being conducted within conventional care at the Internet Psychiatry Unit at Karolinska University Hospital Huddinge. A referral is not necessary, people in the Stockholm County Council catchment area can apply online. Applicants will be given an appointment with a doctor, who will make a diagnosis before the treatment commences.

The current study was funded by the Stockholm County Council.


Effectiveness of Internet-based cognitive behaviour therapy for depression in routine psychiatric care.
Hedman E, Ljótsson B, Kaldo V, Hesser H, El Alaoui S, Kraepelien M, et al
J Affect Disord 2014 Feb;155():49-58