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Effects of a supportive German online program for people with depression or adjustment
ISRCTN ISRCTN02446836
DOI 10.1186/ISRCTN02446836
ClinicalTrials.gov identifier
EudraCT number
Public title Effects of a supportive German online program for people with depression or adjustment
Scientific title Effects of a supportive German online program for people with depression or adjustment: A randomized controlled trial
Acronym N/A
Serial number at source DRKS00004616
Study hypothesis It is expected that an individualized supportive online program in comparison with a non-specific online-based information on depression and health will be more effective in improving disease progression.
Lay summary Background and study aims
Mental illness and behavioral disorders are a major cause of disability and incapacity of work. Scientific studies revealed that the average waiting time from diagnosis to admission to treatment is about five months. Psychological counseling over the internet has the potential to bridge this waiting time. Online applications are characterized by an easy access and the possibility of anonymous usage and could fill supply gaps in underserved regions. The aim of this study is to find out how well a supportive German online program for people with depression or adjustment disorder works in order to alleviate (improve) symptoms and reduce the number of sick days. Considering the rising expenditures of the German health care system for mental disorders, this research project could dedicate important findings for an alternative support system for people suffering from depression or adjustment disorders.

Who can participate?
Women and men between 18 and 65 years with mild to moderate depression or adjustment disorder who are insured by the commercial insurance KKH in Germany.

What does the study involve?
The individualized self-help-program will be compared to online available weekly information texts on depression and health. Participants will receive a personal pseudonymized [process of replacing personally identifiable data with a pseudonym, in order to address privacy concerns] code and are randomly assigned to one of the two groups. Over a period of 12 months beginning in January 2013, online surveys on the health status of the study participants will be conducted at five different times. The online questionnaire is based on standardized diagnostic instruments and was developed in-house. Outcome measures include the alleviation of symptoms and a reduction of sick days. Furthermore, the use of medical care as well as aspects of self-efficacy and the quality of life will be obtained. Analyses will be carried out including anonymized secondary data/routine records of the KKH insurance company.

What are the possible benefits and risks of participating?
The individualized self-help-program is an additive offer of support beyond basic and customary care and may help participants to better manage their symptoms. Participants will be able to use the usually fee-based online program for free. Those who are randomized to the control group with the online offered information texts will have the opportunity to use the individualized self-help program free of cost once the study is completed.
A negative impact on the health of participants is not expected but cannot be ruled out on a case-by-case basis.
It will be recalled that participating in the study cannot replace medical consultations or a therapy. Participants will be reminded to use medical and therapeutic services when needed.

Where is the study run from?
The study is carried out by the Leuphana University Lueneburg.

When is the study starting and how long is it expected to run for?
The study started in January 2013 and will run for 12 months followed by analyses.

Who is funding the study?
The study is funded by the federal state of Lower Saxony, the European Regional Development Fund.

Who is the main contact?
Dr. Joern Moock , Supervisory project coordinator
joern.moock@inkubator.leuphana.de
Ethics approval Committee on ethical issues in research at Leuphana University Lueneburg, 05/12/12
Study design Prospective randomized controlled longitudinal study
Countries of recruitment Germany
Disease/condition/study domain Mild depressive episode, Moderate depressive episode, Recurrent depressive disorder, current episode mild, Recurrent depressive disorder, current episode moderate, Dysthymia, Adjustment disorders
Participants - inclusion criteria 1. The target group consists of insurants of the commercial insurance KKH with a principal diagnosis of mood disorders (F32.0, F32.1, F33.0, F33.1 and F34.1) or adjustment disorder (F43.2) at an age between 18 to 65 years, either sex.
2. Current incapacity to work certificate and an Internet access/e-mail account
Participants - exclusion criteria 1. Presence of severe depression
2. Risk of suicide (dedicated collection of active and passive suicidal tendencies)
3. Missing declaration of consent ("informed consent")
Anticipated start date 14/01/2013
Anticipated end date 15/01/2014
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 608
Interventions Intervention: online intervention with 12 weekly training sessions based on the individual needs of the user including video, audio and written information as well as specific assistance to deal with depressive symptoms.

Control: 12-week online-based written information on depression and health. The written information contains texts, instructions and suggestions for a healthy lifestyle.
Primary outcome measure(s) Improvement of depressive symptoms or symptoms of adjustment disorder (weekly screening by the PHQ-9; pre-post measurement with two follow-ups by the BDI-II)
Secondary outcome measure(s) 1. Reduction of sick days (routine data analysis)
2. Positive effects on patient reported outcomes (PROs; including quality of life, self-efficacy, physical and mental stress symptoms measured by EQ-5D, MANSA, ASF, SCL-14)
3. The use of disease-related services covered by the German statutory health insurance (SHI) (e.g. prescriptions, doctor consultations and hospitalization from routine data analysis)
Sources of funding Federal state of Lower Saxony (Germany) - The European Regional Development Fund, within the framework of the Innovation-Incubator at Leuphana University Lueneburg
Trial website
Publications
Contact name Prof  Wulf  Roessler
  Address Rotenbleicher Weg 67
  City/town Lueneburg
  Zip/Postcode 21335
  Country Germany
  Tel +49 (0)4131 677 7666
  Fax +49 (0)4131 677 7601
  Email roessler@dgsp.uzh.ch
Sponsor NBank (Germany)
  Address European Regional Development Fund (Europäischer Fonds für Regionale Entwicklung Land Niedersachsen)
Günther-Wagner-Allee 12-16
  City/town Hannover
  Zip/Postcode 30177
  Country Germany
  Sponsor website: http://www.efre.niedersachsen.de
Date applied 03/01/2013
Last edited 05/02/2013
Date ISRCTN assigned 05/02/2013
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