Computerized Therapy Equal to Usual Care for Depressed Teens
(HealthDay News) – For adolescents presenting with depressive symptoms, use of a computerized cognitive behavior therapy intervention (SPARX; Smart, Positive, Active, Realistic, X-factor thoughts) is a potential alternative to usual care.
Sally N. Merry, MBChB, from the University of Auckland in New Zealand, and colleagues conducted a multicenter randomized controlled trial involving 187 adolescents, aged 12–19, seeking help for depressive symptoms. Participants were allocated to SPARX (94 adolescents), which comprised seven modules delivered over a period of four to seven weeks, or usual care (93 adolescents), comprising in-person counseling delivered by trained counselors and clinical psychologists.
In per-protocol analyses of 143 participants, the researchers found that SPARX was not inferior to usual care. Post-intervention, the mean reduction in raw scores on the children's depression rating scale-revised was 10.32 in SPARX versus 7.59 in usual care (P=0.079). Compared to usual care, SPARX remission rates were significantly higher (43.7 vs. 26.4%; P=0.03). There was no significant difference between the groups for response rates (66.2 and 58.3% for SPARX and usual care, respectively; P=0.332). Non-inferiority was supported by secondary measures. These findings were confirmed in intention-to-treat analyses and improvements were maintained at three-month follow-up.
"SPARX is an effective resource for adolescents with depressive symptoms. It is at least as good as treatment as usual, would be cheaper and easier to disseminate, and could be used to increase access to therapy," the authors write.