In adults with mild to moderate depression, how effective is computerised cognitive behavioural therapy (CCBT) compared with traditional cognitive behavioural therapy (CBT) (face to face, group or individual), in improving patient outcomes?
Moderate quality evidence from five
RCTs found that there was no difference between CCBT and
traditional CBT. However, most of these trials were small (36 to 69
participants) which may explain why no statistically significant
differences were seen between the groups. The only larger trial
(201 participants) aimed to explore which participant factors were
predictive of treatment outcomes, and was not a report of the main
trial results. Following on from the NICE recommendations, this
indicates that CCBT is an alternative treatment option, but factors
such as the cost, participant's access to a computer and their
preferences for treatment (some may prefer to use the computer,
others may prefer to speak to a professional) should be
Given the small sample sizes and lack
of blinding in most of the existing trials, a larger-scale RCT is
needed. This should be adequately powered to measure depression
outcomes, with a suitable period of follow-up (at least one year)
and blinding of the outcome assessors.
There was a moderate amount of
evidence for answering this question. The evidence from five trials
indicates that there is no difference between CCBT and traditional
CBT. However it should be noted hat most of these trials were small
in size ranging from 36 to 69 participants, and the lack of
statistically significant difference may be due to the size of the
trial. The only large trial of 201 participants was an evaluation
of prognostic factors, rather than a full report of the outcomes
for each treatment group.
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