title: Smartphone-Supported versus Full Behavioural Activation for Depression: A Randomised Controlled Trial.
abstract: BACKGROUND
  There is need for more cost and time effective treatments for depression. This is the first randomised controlled trial in which a blended treatment--including four face-to-face sessions and a smartphone application--was compared against a full behavioural treatment. Hence, the aim of the current paper was to examine whether a blended smartphone treatment was non-inferior to a full behavioural activation treatment for depression.
  
  
  METHODS
  This was a randomised controlled non-inferiority trial (NCT01819025) comparing a blended treatment (n=46) against a full ten-session treatment (n=47) for people suffering from major depression. Primary outcome measure was the BDI-II, that was administered at pre- and post-treatment, as well as six months after the treatment.
  
  
  RESULTS
  Results showed significant improvements in both groups across time on the primary outcome measure (within-group Cohen's d=1.35; CI [-0.82, 3.52] to d=1.47; CI [-0.41, 3.35]; between group d=-0.13 CI [-2.37, 2.09] and d=-0.10 CI [-2.53, 2.33]). At the same time, the blended treatment reduced the therapist time with an average of 47%.
  
  
  CONCLUSIONS
  We could not establish whether the blended treatment was non-inferior to a full BA treatment. Nevertheless, this study points to that the blended treatment approach could possibly treat nearly twice as many patients suffering from depression by using a smartphone application as add-on. More studies are needed before we can suggest that the blended treatment method is a promising cost-effective alternative to regular face-to-face treatment for depression.
  
  
  BACKGROUND
  Cognitive Behavioral Therapy Treatment of Depression With Smartphone Support NCT01819025.
authors.affiliation: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Kien Hoa
authors.initials: KH
authors.lastname: Ly
authors.affiliation: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Naira
authors.initials: N
authors.lastname: Topooco
authors.affiliation: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Cederlund
authors.affiliation: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Wallin
authors.affiliation: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Bergström
authors.affiliation: Wemind Psykiatri Stockholm, Stockholm, Sweden.
authors.forename: Olof
authors.initials: O
authors.lastname: Molander
authors.affiliation: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.affiliation: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003710:Demography; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts; D011569:Psychiatric Status Rating Scales; D000068997:Smartphone; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult