Several meta-analyses have shown that guided self-help through the internet is effective in treating anxiety disorders. However, the cost-effectiveness of guided self-help in regular mental health care has not been studied yet. In the current…
ID
Source
Brief title
Condition
- Anxiety disorders and symptoms
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcomemeasure is the Fear Questionniare. This questionnaire
assesses the level of anxiety (or avoidance) of different situations.
Secondary outcome
Secondary outcomes include: generalised anxiety (BAI), panic (PDSS-R),
depressive symptoms (CES-D), alcohol use (CAGE), satisfaction with care (CSQ8),
quality of life (EQ5-D), health care use and absenteeism. Health care use and
absenteeism will be translated into costs and used in the economical analyses.
We will also register the number (and type) of contacts in regular mental
health care. All questionnaires will be completed via the internet.
Measurements will be conducted after inclusion (and informed consent), after 5
weeks, 3 months, 6 months, 9 months and 12 months.
Background summary
Anxiety disorders cause a high burden of disease. They are ranked second in
comparison with all other somatic and psychiatric diseases. Of all the
different anxiety disorders phobias are the most prevalent ones (social phobia,
specific phobia or agoraphobia). Seventeen percent of the Dutch population
suffers from a phobia of which 11% in the last year. The prevalence of social
phobia is 4.8%, of agoraphobia 1.6% and speficic phobia 7.1%. Moreover, there
is a high co-morbidity rate. Almost half of all patients with a social phobia
also suffer a mood disorder, and almost two thirds suffers from another anxiety
disorder. Next to the high burden of disease, the impairments in daily
functioning, the economic costs are substantial.
Study objective
Several meta-analyses have shown that guided self-help through the internet is
effective in treating anxiety disorders. However, the cost-effectiveness of
guided self-help in regular mental health care has not been studied yet. In the
current project we study the cost-effectiveness of a guided web-based self-help
intervention for phobia patients in regular mental health care. In this
equivalence trail we want to demonstrate that introducing guided self-help
leads to the same clinical effects but costs less.
Study design
We will perform a randomised trial with phobic patients who present themselves
for treatment in regular mental health care. They will be randomised to (1) the
guided web-based self-help intervention or (2) care-as-usual. The self-help
intervention is offered right after the initial registration, during the
waiting period for regular treatment. All patients, in both groups, will be
offered regular treatment after 5 weeks.
Intervention
The intervention is based on a published self-help book (written by drs. Manja
de Neef and prof. Cuijpers), which was used in a series of television programme
on self-help for phobias (by broadcasting company Teleac/Not). This treatment
is based on exposure therapy in which the patients gradually exposes himself or
herself to the feared situation. Exposure has been examined and has been found
to be effective in many studies. The intervention consists of five weeks.
Weekly the patient receives new information as well as home work assignments.
The patients receive weekly feedback online on the homework assignments by
trained coaches. This support is provided by the researchers from the
department of clinical pscyhology. Integrity is checked by an independent
psychotherapist who will review the feedback. The internet-based intervention
is already available and is currently tested in a pilot project.
Study burden and risks
not applicable
van der Boechorststraat 1
1081 BT Amsterdam
NL
van der Boechorststraat 1
1081 BT Amsterdam
NL
Listed location countries
Age
Inclusion criteria
(1) patients with a DSM-IV phobic disorder (social, agora, or specific)
(2) 18 years or older
(3) access to the internet
(4) motivated to work with a guided self-help intervention
Exclusion criteria
Another severe psychological disorder (psychotic disorder, bipolar disorder) and/or an
increased risk for suicide.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL30976.029.10 |