title: Enhancing inpatient psychotherapeutic treatment with online self-help: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Depression is one of the most debilitating and costly mental disorders. There is increasing evidence for the efficacy of online self-help in alleviating depression. Knowledge regarding the options of combining online self-help with inpatient psychotherapy is still limited. Therefore, we plan to evaluate an evidence-based self-help program (deprexis®; Gaia AG, Hamburg, Germany) to improve the efficacy of inpatient psychotherapy and to maintain treatment effects in the aftercare period.
  
  
  METHODS
  Depressed patients (n = 240) with private internet access aged between 18 and 65 are recruited during psychosomatic inpatient treatment. Participants are randomized to an intervention or control group at the beginning of inpatient treatment. The intervention group (n = 120) is offered an online self-help program with 12 weekly tasks, beginning during the inpatient treatment. The control group (n = 120) obtains access to an online platform with weekly updated information on depression for the same duration. Assessments are conducted at the beginning (T0) and the end of inpatient treatment (T1), at the end of intervention (T2) and 6 months after randomization (T3). The primary outcome is the depression score measured by the Beck Depression Inventory-II at T2. Secondary outcome measures include anxiety, self-esteem, quality of life, dysfunctional cognitions and work ability.
  
  
  CONCLUSIONS
  We expect the intervention group to benefit from additional online self-help during inpatient psychotherapy and to maintain the benefits during follow-up. This could be an important approach to develop future concepts of inpatient psychotherapy.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02196896 (registered on 16 July 2014).
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. ruediger.zwerenz@unimedizin-mainz.de.
authors: Rüdiger
authors: R
authors: Zwerenz
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. jan.becker@unimedizin-mainz.de.
authors: Jan
authors: J
authors: Becker
authors: Clinic for Psychosomatic Rehabilitation, Rhön-Klinikum AG, Salzburger Leite 1, 97616 Bad, Neustadt/Saale, Germany. knickenberg.ca@psychosomatische-klinik-bad-neustadt.de.
authors: Rudolf J
authors: RJ
authors: Knickenberg
authors: Clinic for Psychosomatic Rehabilitation, Rhön-Klinikum AG, Salzburger Leite 1, 97616 Bad, Neustadt/Saale, Germany. Karin.Hagen@psychosomatische-klinik-bad-neustadt.de.
authors: Karin
authors: K
authors: Hagen
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. Michael.Dreier@uni-mainz.de.
authors: Michael
authors: M
authors: Dreier
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. woelfling@uni-mainz.de.
authors: Klaus
authors: K
authors: Wölfling
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg-University, Untere Zahlbacher Str. 8, 55131, Mainz, Germany. manfred.beutel@unimedizin-mainz.de.
authors: Manfred E
authors: ME
authors: Beutel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D020407:Internet; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D012107:Research Design; D012648:Self Care / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult