title: A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website.
abstract: BACKGROUND
  In randomized controlled trials Internet sites have been shown to be effective in the treatment of depression and anxiety. However, it is unclear if the positive effects demonstrated in these trials transfer to community users of such sites.
  
  
  OBJECTIVE
  To compare anxiety and depression outcomes for spontaneous visitors to a publicly accessible cognitive behavior therapy website (MoodGYM) (http://moodgym.anu.edu.au) with outcomes achieved through a randomized controlled efficacy trial of the same site.
  
  
  METHODS
  All community visitors to the MoodGYM site between April 2001 and September 2003 were sampled: 182 participants in the BlueMood Trial who had been randomly assigned to the MoodGYM site as part of a large trial and 19607 visitors (public registrants) to the site. Symptom assessments (quizzes) were repeated within the website intervention to allow the examination of change in symptoms across modules. Outcome variables were (1) age, gender, initial depression severity scores, and number of assessments attempted, and (2) symptom change measures based on Goldberg anxiety and depression scores recorded on a least two occasions.
  
  
  RESULTS
  Public registrants did not differ from trial participants in gender, age, or initial level of depression, which was high for both groups relative to previously published epidemiological data sets. Trial participants completed more assessments. No significant differences in anxiety or depression change scores were observed, with both public registrants and trial participants improving through the training program.
  
  
  CONCLUSIONS
  Public registrants to a cognitive behavior therapy website show significant change in anxiety and depression symptoms. The extent of change does not differ from that exhibited by participants enrolled on the website for a randomized controlled trial.
authors.affiliation: Centre for Mental Health Research, The Australian National University, Canberra ACT, 0200, Australia. Helen.Christensen@anu.edu.au
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Griffiths
authors.forename: Ailsa E
authors.initials: AE
authors.lastname: Korten
authors.forename: Kylie
authors.initials: K
authors.lastname: Brittliffe
authors.forename: Chloe
authors.initials: C
authors.lastname: Groves
mesh_terms: D000704:Analysis of Variance; D001007:Anxiety / Q000628:therapy*; D001315:Australia; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D017063:Outcome Assessment, Health Care; D012657:Self-Help Groups; D012737:Sex Factors; D013813:Therapy, Computer-Assisted