title: Effectiveness of transdiagnostic Internet cognitive behavioural treatment for mixed anxiety and depression in primary care.
abstract: BACKGROUND
  Internet-delivered cognitive behavioural treatment (iCBT) has been shown to be effective for the combined treatment of depression and anxiety in randomised controlled trials. The degree to which these findings generalise to patients in primary care awaits further investigation.
  
  
  METHODS
  Using an open-trial design, we investigated adherence to, and effectiveness of a 6-lesson therapist-assisted iCBT program for mixed anxiety and depression for patients (n = 707) who completed the program under the supervision of primary care clinicians (general practitioners, psychologists and other allied health professionals). Primary outcome measures were the PHQ-9 (depression), GAD-7 (generalised anxiety), K-10 (distress), WHODAS-II (disability), mini-SPIN (social anxiety) and panic disorder severity scale self-report version (PDSS).
  
  
  RESULTS
  Adherence to the iCBT program was modest (47.3%), but within-subjects effect sizes ranged from medium (0.51 for PDSS) to large (1.20 for PHQ-9).
  
  
  CONCLUSIONS
  The lack of control group, limited post-treatment data due to drop-out, and short follow-up period.
  
  
  CONCLUSIONS
  iCBT is an effective treatment for mixed depression and anxiety when delivered in primary care settings. Methods to increase adherence are needed to optimise the benefits to patients.
authors.affiliation: Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St. Vincent׳s Hospital, Darlinghurst, NSW, Australia. Electronic address: j.newby@unsw.edu.au.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Newby
authors.affiliation: Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St. Vincent׳s Hospital, Darlinghurst, NSW, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Mewton
authors.affiliation: Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St. Vincent׳s Hospital, Darlinghurst, NSW, Australia.
authors.forename: Alishia D
authors.initials: AD
authors.lastname: Williams
authors.affiliation: Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St. Vincent׳s Hospital, Darlinghurst, NSW, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anxiety; Cognitive behaviour therapy; Depression; Effectiveness; Internet; Treatment