title: Internet-based cognitive behaviour therapy and physical exercise - Effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial.
abstract: OBJECTIVE
  Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances.
  
  
  METHODS
  The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire.
  
  
  RESULTS
  Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p < .001, with weak-to-moderate effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU.
  
  
  CONCLUSIONS
  Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care.
  
  
  CONCLUSIONS
  Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different aspects of patients' health problems. The recruitment of participants was based on patients' interest and inclusion criteria which may have affect the generalizability.
authors.affiliation: Department of Psychology, Lund University, Sweden. catharina.strid@psy.lu.se.
authors.forename: Catharina
authors.identifier: http://orcid.org/0000-0002-8105-2229
authors.initials: C
authors.lastname: Strid
authors.affiliation: Department of Criminology, Malmö University, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Andersson
authors.affiliation: Section for Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Forsell
authors.affiliation: Department of Clinical Sciences, Lund, Psychiatry, Lund, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Öjehagen
authors.affiliation: Department of Psychology, Lund University, Sweden.
authors.forename: Lars-Gunnar
authors.initials: LG
authors.lastname: Lundh
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013689:Telephone; D016896:Treatment Outcome
keywords: Outcome Questionnaire-45; interactive voice response; internet-based cognitive behaviour therapy; mental ill-health; physical exercise