title: Email-based promotion of self-help for subthreshold depression: Mood Memos randomised controlled trial.
abstract: BACKGROUND
  Subthreshold depression is common, impairs functioning and increases the risk of major depression. Improving self-help coping strategies could help subthreshold depression and prevent major depression.
  
  
  OBJECTIVE
  To test the effectiveness of an automated email-based campaign promoting self-help behaviours.
  
  
  METHODS
  A randomised controlled trial was conducted through the website: www.moodmemos.com. Participants received automated emails twice weekly for 6 weeks containing advice about self-help strategies. Emails containing general information about depression served as a control. The principal outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12609000925246).
  
  
  RESULTS
  The study recruited 1326 adults with subthreshold depression. There was a small significant difference in depression symptoms at post-intervention, favouring the active group (d = 0.17, 95% CI 0.01-0.34). There was a lower, although non-significant, risk of major depression in the active group (number needed to treat (NNT) 25, 95% CI 11 to ∞ to NNT(harm) 57).
  
  
  CONCLUSIONS
  Emails promoting self-help strategies were beneficial. Internet delivery of self-help messages affords a low-cost, easily disseminated and highly automated approach for indicated prevention of depression.
authors.affiliation: Orygen Youth Health Research Centre, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia. ajmorgan@unimelb.edu.au
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Morgan
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Jorm
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Mackinnon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000517:prevention & control*; D034742:Electronic Mail; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult