title: Cognitive behaviour therapy via the internet for depression: a useful strategy to reduce suicidal ideation.
abstract: BACKGROUND
  Depression is a major risk factor for suicide. Given the strong association between depression and suicide, treatment for depression should be a fundamental component of suicide prevention. Currently it is not. This study aims to demonstrate the usefulness of internet-delivered cognitive behavioural therapy (iCBT) for depression as a means of reducing suicide ideation.
  
  
  METHODS
  The sample comprised 484 patients who were prescribed iCBT for depression by their primary care physician. The outcomes of interest were major depression, as indexed by the PHQ-8, and suicidal ideation as measured by question 9 of the PHQ-9. Marginal models were used to appropriately analyse available data without biasing parameter estimates.
  
  
  RESULTS
  Following iCBT for depression, suicidal ideation and depression decreased in parallel over time. The prevalence of suicidal ideation reduced from 50% at baseline to 27% after treatment, whilst the prevalence of major depression reduced from 70% to 30%. Depression scores and suicidal ideation decreased after treatment regardless of demographic or clinical variables of interest.
  
  
  CONCLUSIONS
  This is a naturalistic study; randomisation and scientific control were not possible.
  
  
  CONCLUSIONS
  The current study demonstrates the usefulness of iCBT for depression as a means of reducing suicidal ideation which can be implemented on a large scale without enacting major structural change at the societal level. These findings need to be replicated in randomised controlled trials.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia. Electronic address: louisem@unsw.edu.au.
authors.forename: Louise
authors.initials: L
authors.lastname: Mewton
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D059020:Suicidal Ideation; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome; D055815:Young Adult
keywords: Internet cognitive behavioural therapy; Major depression; Suicide