Guided digital health intervention for depression in Lebanon: randomised trial
BackgroundMost people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic....
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creator | Cuijpers, Pim Heim, Eva Ramia, Jinane Abi Burchert, Sebastian Carswell, Kenneth Cornelisz, Ilja Knaevelsrud, Christine Noun, Philip van Klaveren, Chris van’t Hof, Edith Zoghbi, Edwina van Ommeren, Mark El Chammay, Rabih |
description | BackgroundMost people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic.ObjectiveTo examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic.MethodsWe conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment.Findings680 people with depression (PHQ-9>10) and impaired functioning (WHODAS>16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up.ConclusionsGuided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition.Clinical implicationsGuided digital mental health interventions should be considered for implementation in LMICs.Trial registration numberClinicalTrials.gov NCT03720769. |
doi_str_mv | 10.1136/ebmental-2021-300416 |
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fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9811068</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2665561119</sourcerecordid><originalsourceid>FETCH-LOGICAL-b531t-3af27a6d959f6bea0aff16a2610b4b695ec009a1958279582b364df4795e0c4d3</originalsourceid><addsrcrecordid>eNp9kU1PAyEQhonR-P0PjNnEi5dVWGC2eDAxjVaTRi-aeCPswrY0W6iw28R_L021fhy8wAy88zDDi9AJwReEULg01dy4TrV5gQuSU4wZgS20TxgMcgH4dTvFFIocU1buoYMYZxinA17uoj3KeVlyCvvocdRbbXSm7cQmWDY1qu2mmXWdCcvEt95ljQ-ZNotgYlyl1mVjUynn3VUWlNN-bmMidMGq9gjtNKqN5vhzP0Qvd7fPw_t8_DR6GN6M84pT0uVUNUWpQAsuGqiMwqppCKgCCK5YBYKbGmOhiOCDolwtFQWmG5Zig2um6SG6XnMXffoGXadOg2rlIti5Cu_SKyt_3zg7lRO_lGJACIZBApx_AoJ_603sZJqiNm2rnPF9lAUA50AIEUl69kc6831waTxZlBwY51ywpGJrVR18jME0m2YIlivD5JdhcmWYXBuWyk5_DrIp-nIoCfBaUM1n3w__y_wAGTKj9A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2756455594</pqid></control><display><type>article</type><title>Guided digital health intervention for depression in Lebanon: randomised trial</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>ProQuest Central</source><creator>Cuijpers, Pim ; Heim, Eva ; Ramia, Jinane Abi ; Burchert, Sebastian ; Carswell, Kenneth ; Cornelisz, Ilja ; Knaevelsrud, Christine ; Noun, Philip ; van Klaveren, Chris ; van’t Hof, Edith ; Zoghbi, Edwina ; van Ommeren, Mark ; El Chammay, Rabih</creator><creatorcontrib>Cuijpers, Pim ; Heim, Eva ; Ramia, Jinane Abi ; Burchert, Sebastian ; Carswell, Kenneth ; Cornelisz, Ilja ; Knaevelsrud, Christine ; Noun, Philip ; van Klaveren, Chris ; van’t Hof, Edith ; Zoghbi, Edwina ; van Ommeren, Mark ; El Chammay, Rabih</creatorcontrib><description>BackgroundMost people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic.ObjectiveTo examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic.MethodsWe conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment.Findings680 people with depression (PHQ-9>10) and impaired functioning (WHODAS>16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up.ConclusionsGuided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition.Clinical implicationsGuided digital mental health interventions should be considered for implementation in LMICs.Trial registration numberClinicalTrials.gov NCT03720769.</description><identifier>ISSN: 1362-0347</identifier><identifier>EISSN: 1468-960X</identifier><identifier>EISSN: 2755-9734</identifier><identifier>DOI: 10.1136/ebmental-2021-300416</identifier><identifier>PMID: 35577536</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd, Royal College of Psychiatrists and British Psychological Society</publisher><subject>Anxiety ; Coronaviruses ; COVID-19 ; Depression & mood disorders ; Depression - therapy ; Digital Mental Health ; Humans ; Intervention ; Lebanon ; Low income groups ; Mental depression ; Mental disorders ; Mental health ; Pandemics ; Post traumatic stress disorder ; Public health ; Questionnaires ; Self help ; Single-Blind Method ; Well being</subject><ispartof>BMJ mental health, 2022-12, Vol.25 (e1), p.e34-e40</ispartof><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b531t-3af27a6d959f6bea0aff16a2610b4b695ec009a1958279582b364df4795e0c4d3</citedby><cites>FETCH-LOGICAL-b531t-3af27a6d959f6bea0aff16a2610b4b695ec009a1958279582b364df4795e0c4d3</cites><orcidid>0000-0001-5497-2743</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2756455594/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2756455594?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,21367,27901,27902,33721,43781,53766,53768,74273</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35577536$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cuijpers, Pim</creatorcontrib><creatorcontrib>Heim, Eva</creatorcontrib><creatorcontrib>Ramia, Jinane Abi</creatorcontrib><creatorcontrib>Burchert, Sebastian</creatorcontrib><creatorcontrib>Carswell, Kenneth</creatorcontrib><creatorcontrib>Cornelisz, Ilja</creatorcontrib><creatorcontrib>Knaevelsrud, Christine</creatorcontrib><creatorcontrib>Noun, Philip</creatorcontrib><creatorcontrib>van Klaveren, Chris</creatorcontrib><creatorcontrib>van’t Hof, Edith</creatorcontrib><creatorcontrib>Zoghbi, Edwina</creatorcontrib><creatorcontrib>van Ommeren, Mark</creatorcontrib><creatorcontrib>El Chammay, Rabih</creatorcontrib><title>Guided digital health intervention for depression in Lebanon: randomised trial</title><title>BMJ mental health</title><addtitle>Evid Based Ment Health</addtitle><addtitle>Evid Based Mental Health</addtitle><addtitle>Evid Based Ment Health</addtitle><description>BackgroundMost people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic.ObjectiveTo examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic.MethodsWe conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment.Findings680 people with depression (PHQ-9>10) and impaired functioning (WHODAS>16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up.ConclusionsGuided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition.Clinical implicationsGuided digital mental health interventions should be considered for implementation in LMICs.Trial registration numberClinicalTrials.gov NCT03720769.</description><subject>Anxiety</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Depression & mood disorders</subject><subject>Depression - therapy</subject><subject>Digital Mental Health</subject><subject>Humans</subject><subject>Intervention</subject><subject>Lebanon</subject><subject>Low income groups</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Pandemics</subject><subject>Post traumatic stress disorder</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Self help</subject><subject>Single-Blind Method</subject><subject>Well being</subject><issn>1362-0347</issn><issn>1468-960X</issn><issn>2755-9734</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU1PAyEQhonR-P0PjNnEi5dVWGC2eDAxjVaTRi-aeCPswrY0W6iw28R_L021fhy8wAy88zDDi9AJwReEULg01dy4TrV5gQuSU4wZgS20TxgMcgH4dTvFFIocU1buoYMYZxinA17uoj3KeVlyCvvocdRbbXSm7cQmWDY1qu2mmXWdCcvEt95ljQ-ZNotgYlyl1mVjUynn3VUWlNN-bmMidMGq9gjtNKqN5vhzP0Qvd7fPw_t8_DR6GN6M84pT0uVUNUWpQAsuGqiMwqppCKgCCK5YBYKbGmOhiOCDolwtFQWmG5Zig2um6SG6XnMXffoGXadOg2rlIti5Cu_SKyt_3zg7lRO_lGJACIZBApx_AoJ_603sZJqiNm2rnPF9lAUA50AIEUl69kc6831waTxZlBwY51ywpGJrVR18jME0m2YIlivD5JdhcmWYXBuWyk5_DrIp-nIoCfBaUM1n3w__y_wAGTKj9A</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Cuijpers, Pim</creator><creator>Heim, Eva</creator><creator>Ramia, Jinane Abi</creator><creator>Burchert, Sebastian</creator><creator>Carswell, Kenneth</creator><creator>Cornelisz, Ilja</creator><creator>Knaevelsrud, Christine</creator><creator>Noun, Philip</creator><creator>van Klaveren, Chris</creator><creator>van’t Hof, Edith</creator><creator>Zoghbi, Edwina</creator><creator>van Ommeren, Mark</creator><creator>El Chammay, Rabih</creator><general>BMJ Publishing Group Ltd, Royal College of Psychiatrists and British Psychological Society</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5497-2743</orcidid></search><sort><creationdate>20221201</creationdate><title>Guided digital health intervention for depression in Lebanon: randomised trial</title><author>Cuijpers, Pim ; Heim, Eva ; Ramia, Jinane Abi ; Burchert, Sebastian ; Carswell, Kenneth ; Cornelisz, Ilja ; Knaevelsrud, Christine ; Noun, Philip ; van Klaveren, Chris ; van’t Hof, Edith ; Zoghbi, Edwina ; van Ommeren, Mark ; El Chammay, Rabih</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b531t-3af27a6d959f6bea0aff16a2610b4b695ec009a1958279582b364df4795e0c4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anxiety</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Depression & mood disorders</topic><topic>Depression - therapy</topic><topic>Digital Mental Health</topic><topic>Humans</topic><topic>Intervention</topic><topic>Lebanon</topic><topic>Low income groups</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Pandemics</topic><topic>Post traumatic stress disorder</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Self help</topic><topic>Single-Blind Method</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cuijpers, Pim</creatorcontrib><creatorcontrib>Heim, Eva</creatorcontrib><creatorcontrib>Ramia, Jinane Abi</creatorcontrib><creatorcontrib>Burchert, Sebastian</creatorcontrib><creatorcontrib>Carswell, Kenneth</creatorcontrib><creatorcontrib>Cornelisz, Ilja</creatorcontrib><creatorcontrib>Knaevelsrud, Christine</creatorcontrib><creatorcontrib>Noun, Philip</creatorcontrib><creatorcontrib>van Klaveren, Chris</creatorcontrib><creatorcontrib>van’t Hof, Edith</creatorcontrib><creatorcontrib>Zoghbi, Edwina</creatorcontrib><creatorcontrib>van Ommeren, Mark</creatorcontrib><creatorcontrib>El Chammay, Rabih</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology Journals</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ mental health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cuijpers, Pim</au><au>Heim, Eva</au><au>Ramia, Jinane Abi</au><au>Burchert, Sebastian</au><au>Carswell, Kenneth</au><au>Cornelisz, Ilja</au><au>Knaevelsrud, Christine</au><au>Noun, Philip</au><au>van Klaveren, Chris</au><au>van’t Hof, Edith</au><au>Zoghbi, Edwina</au><au>van Ommeren, Mark</au><au>El Chammay, Rabih</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Guided digital health intervention for depression in Lebanon: randomised trial</atitle><jtitle>BMJ mental health</jtitle><stitle>Evid Based Ment Health</stitle><stitle>Evid Based Mental Health</stitle><addtitle>Evid Based Ment Health</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>25</volume><issue>e1</issue><spage>e34</spage><epage>e40</epage><pages>e34-e40</pages><issn>1362-0347</issn><eissn>1468-960X</eissn><eissn>2755-9734</eissn><abstract>BackgroundMost people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic.ObjectiveTo examine the effects of a new WHO-guided digital mental health intervention, Step-by-Step, supported by a non-specialist helper in Lebanon, in the context of concurring economic, humanitarian and political crises, a large industrial disaster and the COVID-19 pandemic.MethodsWe conducted a single-blind, two-arm pragmatic randomised trial, comparing guided Step-by-Step with enhanced care as usual (ECAU) among people suffering from depression and impaired functioning. Primary outcomes were depression (Patient Health Questionnaire 9 (PHQ-9)) and impaired functioning (WHO Disability Assessment Schedule-12 (WHODAS)) at post-treatment.Findings680 people with depression (PHQ-9>10) and impaired functioning (WHODAS>16) were randomised to Step-by-Step or ECAU. Intention-to-treat analyses showed effects on depression (standardised mean differences, SMD: 0.71; 95% CI: 0.45 to 0.97), impaired functioning (SMD: 0.43; 95% CI: 0.21 to 0.65), post-traumatic stress (SMD: 0.53; 95% CI: 0.27 to 0.79), anxiety (SMD: 0.74; 95% CI: 0.49 to 0.99), subjective well-being (SMD: 0.37; 95% CI: 0.12 to 0.62) and self-identified personal problems (SMD: 0.56; 95% CI 0.29 to 0.83). Significant effects on all outcomes were retained at 3-month follow-up.ConclusionsGuided digital mental health interventions can be effective in the treatment of depression in communities exposed to adversities in LMICs, although some uncertainty remains because of high attrition.Clinical implicationsGuided digital mental health interventions should be considered for implementation in LMICs.Trial registration numberClinicalTrials.gov NCT03720769.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd, Royal College of Psychiatrists and British Psychological Society</pub><pmid>35577536</pmid><doi>10.1136/ebmental-2021-300416</doi><orcidid>https://orcid.org/0000-0001-5497-2743</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Anxiety Coronaviruses COVID-19 Depression & mood disorders Depression - therapy Digital Mental Health Humans Intervention Lebanon Low income groups Mental depression Mental disorders Mental health Pandemics Post traumatic stress disorder Public health Questionnaires Self help Single-Blind Method Well being |
title | Guided digital health intervention for depression in Lebanon: randomised trial |
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