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Background: Internet-based interventions produce comparable effectiveness rates as face-to-face therapy in treating depression. Still, more than half of patients do not respond to treatment. Machine learning (ML) methods could help to overcome these low response rates by predicting therapy outcomes on an individual level and tailoring treatment accordingly. Few studies implemented ML algorithms in internet-based depression treatment using baseline self-report data, but differing results hinder inferences on clinical practicability. This work compares algorithms using features gathered at baseline or early in treatment in their capability to predict non-response to a 6-week online program targeting depression. Methods: Our training and test sample encompassed 1270 and 318 individuals, respectively. We trained random forest algorithms on self-report and process features gathered at baseline and after 2 weeks of treatment. Non-responders were defined as participants not fulfilling the criteria for reliable and clinically significant change on PHQ-9 post-treatment. Our benchmark models were logistic regressions trained on baseline PHQ-9 sum or PHQ-9 early change, using 100 iterations of randomly sampled 80/20 train-test-splits. Results: Best performances were reached by our models involving early treatment characteristics (recall: 0.75–0.76; AUC: 0.71–0.77). Therapeutic alliance and early symptom change constituted the most important predictors. Models trained on baseline data were not significantly better than our benchmark. Conclusions: Fair accuracies were only attainable by involving information from early treatment stages. In-treatment adaptation, instead of a priori selection, might constitute a more feasible approach for improving response when relying on easily accessible self-report features. Implementation trials are needed to determine clinical usefulness. [ABSTRACT FROM AUTHOR]

Background: Psychotherapy is effective in treating mental disorders; however, not all patients benefit to the same extent and treatment gains are not always maintained. Blended care (BC) has the potential to improve psychotherapeutic care by combining traditional psychotherapy with online contents. Objective: To explore the potential of BC for psychotherapeutic care and investigate its implementation possibilities. Material and methods: Presentation of the effectiveness of various BC modalities, attitudes of users and decision-makers, and discussion of recommendations for its implementation. Results: Indications for the effectiveness of BC in different modalities has been shown in several studies. Both therapists and patients prefer BC over a purely online intervention and want customizable contents; however, it remains unclear for which patients BC is a particularly suitable treatment option. Conclusion: Various combinations of BC have the potential to be an effective and financially viable treatment option. Successful implementation requires better education about BC and the provision of the necessary infrastructure. [ABSTRACT FROM AUTHOR]

Due to the military aggression of the Russian Federation in Ukraine, citizens experience acute stress, other mental and emotional burdens, and mental disorders. Digital technologies can serve as a tool to improve mental health and psychological support for citizens, especially for those who have limited access to direct contact with a psychotherapist, by developing applications for psychological adaptation and maintaining mental balance. The purpose of the study is to determine the availability and optimal content of mobile applications for the mental health and psychological balance of Ukrainians. A search and analysis of existing solutions in the category of E-MentalHealth (digital services for mental health) in Ukraine and other countries was conducted. An empirical study of their features was conducted, and a proposal for optimal content for mobile applications as auxiliary tools for working with a psychotherapist specialist or for providing psychological assistance to citizens during martial law was formed. To assess the need for such applications, a survey, “My psychological state in the evacuation”, was conducted among respondents outside the country. The online questionnaire “Ukrainians and digital services” was used to determine the most important features among the list of formed offers for optimal application content. It was attended mainly by young people who remained in the country during the military aggression. The results confirmed the need for mobile applications for mental health and psychological assistance among Ukrainian citizens, including those who stayed in the country during the war and those who were evacuated to other countries. Recommendations are given for mandatory features that can be considered technical requirements for developing or improving a multifunctional application in the category of E-Mental-Health

Abstract Background As a new and effective support option, e-mental health interventions can be useful in complementing treatment in mental health care. To date, little is known about how health care providers use these programs to treat patients with mental illnesses in Germany. The present study aims to examine the use of and experiences with e-mental health interventions from the point of view of different types of health care providers for patients with mental illnesses. Methods Data from a cross-sectional survey of routine care health care providers in Germany in 2021 were analysed. In this survey, data were collected from n = 107 general practitioners (GPs), n = 114 specialist doctors, n = 102 psychotherapists, and n = 102 inpatient clinicians. Assessments included professional use of digital media, as well as knowledge, use and experiences regarding e-mental health interventions in care of people with mental illness. Results In the total sample of n = 425, 65.6% (n = 279) were female. The study participants had an average age of 47.7 years (SD = 11.0) and their average work experience was 20.0 years (SD = 11.1). Overall, the majority (83.8%, n = 353) had heard of e-mental health interventions, but few felt well informed. Only 28.5% (n = 121) had already used e-mental health interventions for treatment support. The most commonly recommended e-mental health interventions in the sample were deprexis (39.7%, n = 48), moodgym (24.8%, n = 30), and iFightDepression (22.3%, n = 27). The use was predominantly considered to be helpful and satisfactory. Insufficient knowledge about e-mental health interventions and lack of informational materials for patients were reported as relevant barriers to the use of e-mental health interventions. Conclusions E-mental health interventions can be a useful support option, but they are rarely used in the treatment of patients with mental illnesses. There is a need to disseminate information specific to the various types of health care providers. Tailored implementation strategies need to be developed in order to capitalize on the potential of effective e-mental health interventions and to improve health care for patients with mental illnesses.

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Abstract Background Postpartum depression is a major public health concern, which is associated with negative consequences for both mothers and children. Unfortunately, many affected women neither understand the warning signs of postpartum depression nor do they know where to seek help. The aim of this study was to evaluate the feasibility of SmartMoms, a German mobile web application (web app) designed to inform women about postpartum depression, support them, and provide an easily accessible self-screening instrument. Methods After its development, SmartMoms was distributed through healthcare providers and social media. Feasibility was assessed by examining (1) the experience of postpartum women with the web app, (2) user behaviour, and (3) the experience of healthcare providers with the web app and its distribution. A mixed methods approach was used, including online surveys, usage data, and interviews. Results Most women used SmartMoms to prevent postpartum depression and rated the web app as good (on average 4.36 out of 5 stars). The majority of women (62.2%) accessing the self-screening instrument showed a risk for postpartum depression (Edinburgh Postnatal Depression scale score ≥ 12). Most providers (n = 12/13) felt supported through SmartMoms in discussing postpartum depression and considered it a useful offer. Suggestions for improvement were provided. Conclusions SmartMoms meets the needs and expectations of mothers and healthcare providers interested in postpartum depression but should be further adapted to include more specific support options and additional information for professionals.

Background: As a new and effective support option, e-mental health interventions can be useful in complementing treatment in mental health care. To date, little is known about how health care providers use these programs to treat patients with mental illnesses in Germany. The present study aims to examine the use of and experiences with e-mental health interventions from the point of view of different types of health care providers for patients with mental illnesses. Methods: Data from a cross-sectional survey of routine care health care providers in Germany in 2021 were analysed. In this survey, data were collected from n = 107 general practitioners (GPs), n = 114 specialist doctors, n = 102 psychotherapists, and n = 102 inpatient clinicians. Assessments included professional use of digital media, as well as knowledge, use and experiences regarding e-mental health interventions in care of people with mental illness. Results: In the total sample of n = 425, 65.6% (n = 279) were female. The study participants had an average age of 47.7 years (SD = 11.0) and their average work experience was 20.0 years (SD = 11.1). Overall, the majority (83.8%, n = 353) had heard of e-mental health interventions, but few felt well informed. Only 28.5% (n = 121) had already used e-mental health interventions for treatment support. The most commonly recommended e-mental health interventions in the sample were deprexis (39.7%, n = 48), moodgym (24.8%, n = 30), and iFightDepression (22.3%, n = 27). The use was predominantly considered to be helpful and satisfactory. Insufficient knowledge about e-mental health interventions and lack of informational materials for patients were reported as relevant barriers to the use of e-mental health interventions. Conclusions: E-mental health interventions can be a useful support option, but they are rarely used in the treatment of patients with mental illnesses. There is a need to disseminate information specific to the various types of health care providers. Tailored implementation strategies need to be developed in order to capitalize on the potential of effective e-mental health interventions and to improve health care for patients with mental illnesses. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression is a major public health concern, which is associated with negative consequences for both mothers and children. Unfortunately, many affected women neither understand the warning signs of postpartum depression nor do they know where to seek help. The aim of this study was to evaluate the feasibility of SmartMoms, a German mobile web application (web app) designed to inform women about postpartum depression, support them, and provide an easily accessible self-screening instrument. Methods: After its development, SmartMoms was distributed through healthcare providers and social media. Feasibility was assessed by examining (1) the experience of postpartum women with the web app, (2) user behaviour, and (3) the experience of healthcare providers with the web app and its distribution. A mixed methods approach was used, including online surveys, usage data, and interviews. Results: Most women used SmartMoms to prevent postpartum depression and rated the web app as good (on average 4.36 out of 5 stars). The majority of women (62.2%) accessing the self-screening instrument showed a risk for postpartum depression (Edinburgh Postnatal Depression scale score ≥ 12). Most providers (n = 12/13) felt supported through SmartMoms in discussing postpartum depression and considered it a useful offer. Suggestions for improvement were provided. Conclusions: SmartMoms meets the needs and expectations of mothers and healthcare providers interested in postpartum depression but should be further adapted to include more specific support options and additional information for professionals. [ABSTRACT FROM AUTHOR]

The outbreak of the COVID-19 pandemic and associated measures to contain the SARS-CoV-2 coronavirus required a change in treatment format from face-to-face to remote psychotherapy. This study investigated the changes experienced by Austrian therapists when switching to psychotherapy at a distance. A total of 217 therapists participated in an online survey on changes experienced when switching settings. The survey was open from 26 June until 3 September 2020. Several open questions were evaluated using qualitative content analysis. The results show that the setting at a distance was appreciated by the therapists as a possibility to continue therapy even during an exceptional situation. Moreover, remote therapy offered the respondents more flexibility in terms of space and time. Nevertheless, the therapists also reported challenges of remote therapy, such as limited sensory perceptions, technical problems and signs of fatigue. They also described differences in terms of the therapeutic interventions used. There was a great deal of ambivalence in the data regarding the intensity of sessions and the establishment and/or maintenance of a psychotherapeutic relationship. Overall, the study shows that remote psychotherapy seems to have been well accepted by Austrian psychotherapists in many settings and can offer benefits. Clinical studies are also necessary to investigate in which contexts and for which patient groups the remote setting is suitable and where it is potentially contraindicated. [ABSTRACT FROM AUTHOR]

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• RECOVER showed higher cost savings and cost-effectiveness. • RECOVER showed equivalent quality of clinical care and improved access to care. • RECOVER shows the successful implementation of stepped care. Stepped, evidence-based and integrated care service models have the potential to be used as a reference for mental health services. RECOVER aimed to evaluate cost savings, effectiveness, and cost-effectiveness of such a model within a two arm, assessor- and data analysist-blinded RCT in Hamburg, Germany. Participants aged 16–79 years with mental disorders were randomly assigned either to RECOVER or treatment as usual (TAU). Primary outcomes comprised costs, effectiveness (combined symptoms, functioning, quality of life), and cost-effectiveness, hierarchically ordered. Outcomes were evaluated according to the ITT principle, group differences regarding costs with adjusted generalized linear models, effectiveness with ANCOVA models, and cost-effectiveness with the incremental cost-effectiveness ratio (ICER) and cost-effectiveness acceptability curves (CEACs). Between 1/1/2018 and 12/31/2020, n = 891 were finally included (n = 477 in RECOVER, n = 444 in TAU). RECOVER was associated with significantly lower annual total costs (-22 %), health and social care costs (-25 %) and hospital costs (-50 %). Effectiveness analyses showed a significantly better outcome for RECOVER with the fully imputed data. The CEACs descriptively demonstrated that RECOVER was cost-effective with a probability of >95 %. Treatment in RECOVER resulted in substantial cost reductions with better cost-effectiveness. RECOVER can be recommended as a reference model for comprehensive and integrated mental health services. [ABSTRACT FROM AUTHOR]

Background: E‑mental health mainly plays a role in the outpatient treatment of patients with depressive disorders. The goal of this study was to implement and evaluate the web-based, therapist-guided self-management tool "iFightDepression" (iFD) to clarify if there is a benefit for inpatient use. Material and methods: In this study 78 inpatients with affective disorders (ICD-10 F32.0‑3, F33.0-3) or dysthymia (F34) were recruited. The intervention duration with the iFD tool went from admission until discharge, therapeutic support was granted by the ward staff. Symptom severity, intervention expectations and experience with therapy were processed in an online questionnaire before the intervention (T0) while intervention satisfaction was captured after the intervention shortly before discharge (T1) in a paper-pencil questionnaire. Results: Out of 78 participating inpatients 42 used the iFD tool at least once. Moderate to high levels of expectation regarding the iFD tool and mildly above-average level of satisfaction after the intervention were observed. Of the active users 67% indicated they would continue to use the iFD tool after discharge. The main reasons for not using the iFD tool were short duration of stay, severity of disease and lack of digital literacy. Conclusion: An implementation of the iFD tool is feasible on principle. Active users gave positive feedback concerning the intervention and most participants claimed to continue using the iFD tool after discharge; however, low usage rates among study participants (42/78, 54%) showed barriers of implementation that have to be addressed and underline the importance of adaptations regarding the use of the intervention in a clinical setting. [ABSTRACT FROM AUTHOR]

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Abstract Background Depressive disorders often remain undiagnosed or are treated inadequately. Online-based programs may reduce the present treatment gap for depressive disorders and reduce disease-related costs. This study aimed to examine the potential of the internet intervention “deprexis” to reduce the total costs of statutory health insurance. Changes in depression severity, health-related quality of life and impairment in functioning were also examined. Method A total of 3805 participants with, at minimum, mild depressive symptoms were randomized to either a 12-week online intervention (deprexis) or a control condition. The primary outcome measure was statutory health insurance costs, estimated using health insurers’ administrative data. Secondary outcomes were: depression severity, health-related quality of life, and impairment in functioning; assessed on patient’s self-report at baseline, post-treatment, and three-months’ and nine-months’ follow-up. Results In both groups, total costs of statutory health insurance decreased during the study period, but changes from baseline differed significantly. In the intervention group total costs decreased by 32% from 3139€ per year at baseline to 2119€ in the study year (vs. a mean reduction in total costs of 13% in the control group). In comparison to the control group, the intervention group also showed a significantly greater reduction in depression severity, and impairment in functioning and a significantly greater increase in health-related quality of life. Conclusion The study underlines the potential of innovative internet intervention programs in treating depressive disorders. The results suggest that the use of deprexis over a period of 12 weeks leads to a significant improvement in symptoms with a simultaneous reduction in the costs of statutory health insurance.

IntroductionChildren of parents with mental disorders have a high chance of developing a mental disorder themselves. However, this at-risk group is regularly overlooked and typically not seen by any mental health professionals. Internet- and mobile-based interventions (IMIs) can provide a means of promoting mental health for children of parents with mental disorders.ObjectiveThe introduced study will evaluate the clinical- and cost-effectiveness of the iCHIMPS IMI in promoting mental health for children of parents with mental disorders.MethodsA two-armed multicentered cluster-randomized controlled trial (cRCT) comparing the clinical- and cost-effectiveness of the iCHIMPS IMI in the intervention group (IG) to a treatment-as-usual (TAU) control group will be conducted. Recruitment will be handled at currently 21 adult mental health clinics throughout Germany. Participating families will be randomly divided into the two groups until the final sample size of 306 participating adolescents (age 12–18) has been reached. The adolescents in the intervention group will receive access to the IMI and can take part in up to eight intervention modules. Assessment will be conducted during the recruitment (baseline), 1-month, 2-months, and 6-month post-inclusion. Primary outcome is the mental health of the participating adolescents at 6-months post-inclusion as measured by the Youth Self Report score. Secondary self-report outcomes are mental wellbeing, self-efficacy, coping strategies and negative effects as well as mental health of the adolescents as reported by their parent(s). Included moderators are sociodemographic characteristics, working alliance, social support and the mental health diagnoses of the parents. Statistical analyses will be conducted on the intention-to-treat principle as well as with additional per-protocol analyses. Additionally, the cost-effectiveness as well as qualitative data concerning the adherence, acceptance, and feasibility of the IMI will be analyzed.DiscussionThe iCHIMPS cRCT examines the clinical- as well as cost-effectiveness of the iCHIMPS mental health promotion IMI for children of parents with mental disorders. This provides the opportunity to gain insights into an innovative as well as time- and location-independent form of support for this often-overlooked at-risk group. Additionally, the larger CHIMPS-NET project allows comparisons between internet-based and face-to-face interventions for a similar target group.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: DRKS00025158.

The outbreak of the COVID-19 pandemic and associated measures to contain the SARS-CoV-2 coronavirus required a change in treatment format from face-to-face to remote psychotherapy. This study investigated the changes experienced by Austrian therapists when switching to psychotherapy at a distance. A total of 217 therapists participated in an online survey on changes experienced when switching settings. The survey was open from 26 June until 3 September 2020. Several open questions were evaluated using qualitative content analysis. The results show that the setting at a distance was appreciated by the therapists as a possibility to continue therapy even during an exceptional situation. Moreover, remote therapy offered the respondents more flexibility in terms of space and time. Nevertheless, the therapists also reported challenges of remote therapy, such as limited sensory perceptions, technical problems and signs of fatigue. They also described differences in terms of the therapeutic interventions used. There was a great deal of ambivalence in the data regarding the intensity of sessions and the establishment and/or maintenance of a psychotherapeutic relationship. Overall, the study shows that remote psychotherapy seems to have been well accepted by Austrian psychotherapists in many settings and can offer benefits. Clinical studies are also necessary to investigate in which contexts and for which patient groups the remote setting is suitable and where it is potentially contraindicated.

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Abstract Background Depression often remains undiagnosed or treated inadequately. Web-based interventions for depression may improve accessibility of treatment and reduce disease-related costs. This study aimed to examine the potential of the web-based cognitive behavioral intervention “deprexis” in reducing disease-related costs. Methods Participants with mild to moderate depressive symptoms were recruited and randomized to either a 12-week web-based intervention (deprexis) in addition to care as usual (intervention group) or care as usual (control group). Outcome measures were health-related resource use, use of medication and incapacity to work as well as relating direct health care costs. Outcomes were assessed on patients’ self-report at baseline, three months and six months. Results A total of 1013 participants were randomized. In both groups total direct health care costs decreased during the study period, but changes from baseline did not significantly differ between study groups. Numeric differences between study groups existed in outpatient treatment costs. They could be attributed to differences in changes of costs for psychotherapeutic treatment from baseline. Whereas costs for psychotherapeutic treatment decreased in the intervention group, costs increased in the control group (− 16.8% (€80) vs. + 14.7% (€60)) (tdf = 685 = 2.57; p = 0.008). Conclusion The study indicates the health economic potential of innovative e-mental-health programs. There is evidence to suggest that the use of deprexis over a period of 12 weeks leads to a decrease in outpatient treatment cost, especially in those related to different types of psychotherapeutic treatment.

Introduction: Internet- and mobile-based interventions (IMIs) and their integration into routine psychotherapy (i.e., blended therapy) can offer a means of complementing psychotherapy in a flexible and resource optimized way. Objective: The present study will evaluate the non-inferiority, cost-effectiveness, and safety of two versions of integrated blended psychotherapy for depression and anxiety compared to standard cognitive behavioral therapy (CBT). Methods: A three-armed multicenter cluster-randomized controlled non-inferiority trial will be conducted comparing two implementations of blended psychotherapy (PSYCHOnlineTHERAPYfix/flex) compared to CBT. Seventy-five outpatient psychotherapists with a CBT-license will be randomized in a 1:1:1 ratio. Each of them is asked to include 12 patients on average with depressive or anxiety disorders resulting in a total sample size of N = 900. All patients receive up to a maximum of 16 psychotherapy sessions, either as routine CBT or alternating with Online self-help sessions (fix: 8/8; flex: 0–16). Assessments will be conducted at patient study inclusion (pre-treatment) and 6, 12, 18, and 24 weeks and 12 months post-inclusion. The primary outcome is depression and anxiety severity at 18 weeks post-inclusion (post-treatment) using the Patient Health Questionnaire Anxiety and Depression Scale. Secondary outcomes are depression and anxiety remission, treatment response, health-related quality of life, patient satisfaction, working alliance, psychotherapy adherence, and patient safety. Additionally, several potential moderators and mediators including patient characteristics and attitudes toward the interventions will be examined, complemented by ecological day-to-day digital behavior variables via passive smartphone sensing as part of an integrated smart-sensing sub-study. Data-analysis will be performed on an intention-to-treat basis with additional per-protocol analyses. In addition, cost-effectiveness and cost-utility analyses will be conducted from a societal and a public health care perspective. Additionally, qualitative interviews on acceptance, feasibility, and optimization potential will be conducted and analyzed. Discussion: PSYCHOnlineTHERAPY will provide evidence on blended psychotherapy in one of the largest ever conducted psychotherapy trials. If shown to be non-inferior and cost-effective, PSYCHOnlineTHERAPY has the potential to innovate psychotherapy in the near future by extending the ways of conducting psychotherapy. The rigorous health care services approach will facilitate a timely implementation of blended psychotherapy into standard care. Trial Registration: The trial is registered in the German Clinical Trials Register (DRKS00023973; date of registration: December 28th 2020). [ABSTRACT FROM AUTHOR]

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Background: Depressive disorders often remain undiagnosed or are treated inadequately. Online-based programs may reduce the present treatment gap for depressive disorders and reduce disease-related costs. This study aimed to examine the potential of the internet intervention "deprexis" to reduce the total costs of statutory health insurance. Changes in depression severity, health-related quality of life and impairment in functioning were also examined. Method: A total of 3805 participants with, at minimum, mild depressive symptoms were randomized to either a 12-week online intervention (deprexis) or a control condition. The primary outcome measure was statutory health insurance costs, estimated using health insurers' administrative data. Secondary outcomes were: depression severity, health-related quality of life, and impairment in functioning; assessed on patient's self-report at baseline, post-treatment, and three-months' and nine-months' follow-up. Results: In both groups, total costs of statutory health insurance decreased during the study period, but changes from baseline differed significantly. In the intervention group total costs decreased by 32% from 3139€ per year at baseline to 2119€ in the study year (vs. a mean reduction in total costs of 13% in the control group). In comparison to the control group, the intervention group also showed a significantly greater reduction in depression severity, and impairment in functioning and a significantly greater increase in health-related quality of life. Conclusion: The study underlines the potential of innovative internet intervention programs in treating depressive disorders. The results suggest that the use of deprexis over a period of 12 weeks leads to a significant improvement in symptoms with a simultaneous reduction in the costs of statutory health insurance. [ABSTRACT FROM AUTHOR]

Technische Fortschritte in den letzten 20 Jahren eröffnen neue Chancen in Bezug auf umfangreiche Datenerhebungen und neue Interventionsformen im Gesundheitsbereich, im Speziellen in der Psychotherapie. Computergestützte Ansätze werden unter dem Begriff E-Mental-Health zusammengefasst und können auf dem Weg für eine evidenzbasierte Personalisierung in der ambulanten Face-to-Face Psychotherapie unterstützen (Precision Mental Health). Diese auch unter dem Begriff "blended mental health" bekannt gewordene Variante einer empirisch gestützten Personalisierung kann sowohl die Planung der Behandlung zu Therapiebeginn, als auch die Anpassung im Behandlungsverlauf [eProzessdiagnostik] beinhalten. Exemplarisch wird eine mögliche Umsetzung der Personalisierung in der klinischen Praxis anhand des Trierer Therapie Navigators (TTN) aufgezeigt sowie die zugrundeliegenden Forschungskonzepte dargestellt. Im TTN werden datengestützte Anpassungen im Behandlungsverlauf durch eProzessdiagnostik, Feedback und Unterstützungshilfen in fünf klinischen Therapiefeldern (1. Krisenmanagement/Suizidalität; 2. Motivation/Therapieziele; 3. Therapiebeziehung/Interpersonale Fähigkeiten; 4. Soziale Unterstützung/Kritische Lebensereignisse; 5. Emotions- und Selbstregulation) ermöglicht. Insbesondere bei Patientinnen und Patienten mit einem erhöhten Risiko für einen ungünstigen Verlauf oder Therapieabbruch (Dropout) ist eine solche Feedback-gestützte Therapie hilfreich. Abschließend werden Perspektiven zur Weiterentwicklung, z.B. Nutzung zusätzlicher Datenquellen, und zur Umsetzung in der klinischen Aus- und Weiterbildung diskutiert. [ABSTRACT FROM AUTHOR]

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Background: Currently, the debate on regional and socio-structurally related treatment gaps in psychotherapeutic care increases the interest in e-mental health interventions such as the Internet-based psychotherapy, online self-help and new approaches for self-empowerment. Thus, health professionals could support informed decision-making by knowing the latest developments. However, if the ‘digital revolution’ fails to reach patients not familiar with Web 2.0, access to psychotherapies is unlikely to improve. Therefore, the objective of this review is to clarify whether online therapies should be recommended as an effective alternative to conventional psychotherapy in primary care.

The number of evidence-based online psychotherapeutic interventions has been increasing in recent years. This raises the question whether personality traits have an impact on the use and success of online interventions. Initial findings indicate that broad (e. g. openness to experiences, conscientiousness) and narrow personality traits (e. g. attitude towards online psychotherapeutic interventions) are relevant predictors. Despite limited data for differential effects in clinical samples, personality traits represent an important source of effective, tailored psychotherapy, given the variety of online psychotherapeutic interventions for different psychological disorders. From a methodological point of view, online psychotherapy research enables multimodal assessment and aggregation of different data sources. This allows a reliable and valid assessment of personality and its facets. [ABSTRACT FROM AUTHOR]

Hintergrund: Mit Resilienz wird eine positive und ressourcenorientierte Perspektive verbunden, weshalb sie als Thema für Gesundheitsförderung und Prävention besonders attraktiv erscheint. In den letzten Jahren wurden vermehrt Interventionen zur Förderung von Resilienz entwickelt, die Resilienzfaktoren trainieren und überwiegend in einem Face-to-face-Gruppenformat stattfinden.Fragestellung: Es wird die Frage untersucht, welches Potenzial internetbasierte Interventionen (i-Interventionen) zum Training von Resilienzfaktoren für die Gesundheitsförderung und Prävention haben.Material und Methoden: Auf der Grundlage eines narrativen Überblicks werden die Möglichkeiten von i‑Interventionen, die Resilienzfaktoren trainieren, zur Gesundheitsförderung und Prävention untersucht und der Forschungsstand dargestellt.Ergebnisse: Die Effekte der hier dargestellten i‑Interventionen, die das Ziel einer Resilienzförderung verfolgen, auf Maße der psychischen Gesundheit und des Wohlbefindens sind heterogen und variieren von geringen bis zu hohen Effekten. Stärkere Evidenz für die Wirksamkeit auf diese Maße liegt für i‑Interventionen vor, die zwar auch Resilienzfaktoren trainieren, aber zur Prävention spezifischer Erkrankungen wie Depressionen oder zur Stressreduktion konzipiert sind.Diskussion: Die Heterogenität der Evidenz wird vor dem Hintergrund heterogener Trainingsinhalte, theoretischer Grundlagen sowie eingesetzter therapeutischer Methoden diskutiert. Zusätzlich werden Perspektiven für die Weiterentwicklung ressourcenorientierter Resilienztrainings skizziert. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Among the most important innovations within the psychotherapeutic care system are the new opportunities in the field of e-mental health. During the past decade, Internet-based and other e-mental health approaches for the treatment of post-traumatic stress disorder and related stress-associated symptoms have been developed in great variety. Solely Internet-based self-help programs are the lowest-threshold approaches in a stepped-care system. By contrast, individualized online psychotherapy and virtual reality programs are at the opposite pole of the spectrum. Approaches in the field of m(obile)-mental health complement these new developments in psychotherapy. The existing evidence supports the clinical efficacy of all the described approaches, although not all have been tested rigorously analog to phase III studies in psychopharmacology. Nonetheless, e-mental health approaches will shape our field more and more in the future. [ABSTRACT FROM AUTHOR]

Hintergrund: Ziel der Studie ist es, die Wirkung eines smartphonegestützten kognitiv-behavioralen Rehabilitationsnachsorgeprogramms (eATROS) für Patienten mit depressiven Störungen zu überprüfen, die mit Erfolg an einer stationären psychosomatischen Rehabilitationsmaßnahme teilgenommen hatten. eATROS dient dazu, den Behandlungserfolg zu sichern und Rückfällen vorzubeugen. Die Smartphone-Anwendung soll die Patienten in den ersten 3 Monaten nach Entlassung bei der Umsetzung ihrer antidepressiven Verhaltensstrategien unterstützen. Methoden: Die Studie wurde als prospektive Kontrollgruppenstudie realisiert, mit ambulanter, poststationärer Regelversorgung (TAU) als Kontrollbedingung (KG) und einer Experimentalgruppe (EG), die zusätzlich Nachsorge mit eATROS erhielt. In die Studie aufgenommen und den beiden Versuchsgruppen in wochenweise gebildeten Kohorten zufällig zugewiesen wurden Patienten mit affektiven Störungen als Hauptbehandlungsdiagnose, die im Zuge der Behandlung eine einzelfallstatistisch signifikante Besserung ihrer depressiven Symptomatik erzielt hatten. Patienten der EG erhielten das Angebot, eATROS in den ersten 3 Monaten nach ihrer Entlassung in Anspruch zu nehmen. Am Anfang und Ende dieser poststationären Phase wurden die Depressivität und depressionsrelevante Selbstregulationskompetenzen als Zielgrößen erhoben. Ergebnisse: Im Vergleich zu den Patienten der KG (n = 42) gelang es den Patienten der EG (n = 50) ihre während der stationären Rehabilitationsmaßnahme erreichte Reduktion der Depressionssymptomatik besser aufrechtzuerhalten. Hinsichtlich der Selbstregulationskompetenzen ließ sich die Überlegenheit der eATROS-Nachsorge gegenüber der KG für 2 der 5 eingesetzten Skalen nachweisen: Die Patienten der eATROS-Nachsorge wiesen eine günstigere Entwicklung ihrer Kompetenzen auf, sich selbst zu motivieren und Absichten umzusetzen, als die Patienten der KG. Diskussion: Die Wirkkomponenten der eATROS-Intervention werden diskutiert und Möglichkeiten und Grenzen für den Transfer in die Versorgungspraxis erörtert. Schlussfolgerung: Die Ergebnisse sprechen - mit methodischen Einschränkungen - für die Überlegenheit der smartphonegestützten Rehabilitationsnachsorge gegenüber poststationärer Regelversorgung allein. [ABSTRACT FROM AUTHOR]

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Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hintergrund: Ziel der Studie ist es, die Wirksamkeit einer Handheld-gestützten Form der ambulanten Nachsorge (E-Coaching) nach stationärer psychosomatischer Rehabilitation bei Patienten zu überprüfen, die eine übermäßige berufliche Verausgabungsbereitschaft aufweisen. Die Patienten wurden mehrmals am Tag programmgesteuert aufgefordert, die Aufmerksamkeit auf ihr derzeitiges Verhalten und Erleben zu richten, es daraufhin zu überprüfen, ob es die Entstehung körperlicher oder seelischer Symptome begünstigt, es gegebenenfalls im Sinne der in der Behandlung erarbeiteten Strategien zu korrigieren und nach einer Zeit zu kontrollieren, ob diese Korrekturen erfolgreich waren. Methoden: Die Patienten, die die Ein- und Ausschlusskriterien erfüllten, nahmen am Ende des stationären Aufenthalts an einer Kurzbehandlung teil, in der sie E-Coaching kennenlernten und erproben konnten. Zwei Drittel erlebten E-Coaching als hilfreich. Diese Patienten wurden nach einem «randomized consent design» auf die Experimentgruppe (E-Coaching) und die Kontrollgruppe (Vorsatz-Therapie ohne Handheld) verteilt. Die Interventionen fanden in den 6 Monaten nach Entlassung jeweils 2 Mal 7 Tage lang statt. Als primäre Zielgröße wurde berufsbezogene Verausgabungsbereitschaft und als sekundäre Zielgrößen Selbstmanagementfähigkeiten und Beschwerdedruck jeweils am Anfang und am Ende der poststationären Phase sowie ein Jahr nach Entlassung mit standardisierten Verfahren erhoben. Ergebnisse: Die Patienten beider Versuchsgruppen (EG: n = 74, KG: n = 48) konnten den während der stationären Rehabilitationsmaßnahme erreichten Behandlungserfolg hinsichtlich des Beschwerdedrucks aufrechterhalten. Hinsichtlich der im stationären Bereich erzielten positiven Effekte bei der Verausgabungsbereitschaft erreichten sie sogar eine weitere Reduktion. Allerdings war hinsichtlich keiner der Zielgrößen E-Coaching der Vorsatz-Therapie überlegen. Diskussion: Es werden Ursachen der Ergebnisse und Verbesserungsvorschläge für E-Coaching-Prozeduren erörtert. [ABSTRACT FROM AUTHOR]

Hintergrund: Über den Zusammenhang zwischen der Teilnahme an E-Mental-Health-Interventionen und der Inanspruchnahme regulärer Psychotherapie ist bisher wenig bekannt. In der vorliegenden Studie wurde untersucht, inwiefern ein SMS-basiertes Nachsorgeprogramm mit einem veränderten Inanspruchnahmeverhalten ambulanter Therapie im Anschluss an eine stationäre Behandlung für Essstörungen assoziiert ist. Methode: 165 Patientinnen, die aufgrund einer vollausgeprägten oder subsyndromalen Bulimia nervosa stationär behandelt wurden, wurden randomisiert jeweils einer Kontrollgruppe (KG: treatment as ususal (TAU)) oder Interventionsgruppe (IG: 16-wöchige Nachsorge über SMS zusätzlich zu TAU) zugewiesen. Erfasst wurden die Rückfallrate und die Inanspruchnahme ambulanter Therapie innerhalb des 8-monatigen Follow-up-Zeitraums. Ergebnisse: In der KG wurden signifikant mehr Rückfälle beobachtet als in der IG (KG: 42,0%; IG: 26,8%). Vergleichbar viele Teilnehmerinnen nahmen ambulante Therapie in Anspruch (KG: 52,2%; IG: 53,5%). Innerhalb der Teilnehmerinnen, die eine ambulante Therapie aufnahmen, unterschieden sich die Rückfallraten von KG und IG nicht signifikant (KG: 38,9%; IG: 28,9%). Ein bedeutsamer Unterschied wurde hingegen in der Untergruppe festgestellt, die keine ambulante Therapie nutzte (KG: 45,5%; IG: 24,2%). Schlussfolgerung: Die Studie unterstreicht den Bedarf an sektorenübergreifenden Versorgungsangeboten (stationär-ambulant). Die Studie liefert erste Hinweise, dass das SMS-Programm das Inanspruchnahmeverhalten bezüglich ambulanter Therapie positiv beeinflussen könnte. Weitere Studien sind notwendig, um diesen möglichen kausalen Effekt zu untersuchen. [ABSTRACT FROM AUTHOR]

Copyright of Psychotherapeut is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Children of parents with mental disorders have a high chance of developing a mental disorder themselves. However, this at-risk group is regularly overlooked and typically not seen by any mental health professionals. Internet- and mobile-based interventions (IMIs) can provide a means of promoting mental health for children of parents with mental disorders., Objective: The introduced study will evaluate the clinical- and cost-effectiveness of the iCHIMPS IMI in promoting mental health for children of parents with mental disorders., Methods: A two-armed multicentered cluster-randomized controlled trial (cRCT) comparing the clinical- and cost-effectiveness of the iCHIMPS IMI in the intervention group (IG) to a treatment-as-usual (TAU) control group will be conducted. Recruitment will be handled at currently 21 adult mental health clinics throughout Germany. Participating families will be randomly divided into the two groups until the final sample size of 306 participating adolescents (age 12-18) has been reached. The adolescents in the intervention group will receive access to the IMI and can take part in up to eight intervention modules. Assessment will be conducted during the recruitment (baseline), 1-month, 2-months, and 6-month post-inclusion. Primary outcome is the mental health of the participating adolescents at 6-months post-inclusion as measured by the Youth Self Report score. Secondary self-report outcomes are mental wellbeing, self-efficacy, coping strategies and negative effects as well as mental health of the adolescents as reported by their parent(s). Included moderators are sociodemographic characteristics, working alliance, social support and the mental health diagnoses of the parents. Statistical analyses will be conducted on the intention-to-treat principle as well as with additional per-protocol analyses. Additionally, the cost-effectiveness as well as qualitative data concerning the adherence, acceptance, and feasibility of the IMI will be analyzed., Discussion: The iCHIMPS cRCT examines the clinical- as well as cost-effectiveness of the iCHIMPS mental health promotion IMI for children of parents with mental disorders. This provides the opportunity to gain insights into an innovative as well as time- and location-independent form of support for this often-overlooked at-risk group. Additionally, the larger CHIMPS-NET project allows comparisons between internet-based and face-to-face interventions for a similar target group., Clinical Trial Registration: www.ClinicalTrials.gov, identifier: DRKS00025158., Competing Interests: The study team of the Ulm University are authors of this manuscript and have developed the internet and mobile-based intervention iCHIMPS. Hence, the final statistical analysis will be conducted by independent evaluators from Ulm University and the Center for Health Economic Research in Hannover (CHERH). HB received consultancy fees, reimbursement of congress attendance and travel costs as well as payments for lectures from Psychotherapy and Psychiatry Associations as well as Psychotherapy Training Institutes in the context of E-Mental-Health topics. He has been the beneficiary of study support (third-party funding) from several public funding organizations. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dülsen, Barck, Daubmann, Höller, Zeidler, Kilian, Wiegand-Grefe and Baumeister.)

Fear of being stigmatized by others, self-stigmatization, and inadequate information can limit those affected by suicidality from seeking help. E‑mental-health interventions provide a low-threshold way to reach many individuals with information about the topic. This enables those affected to prepare themselves for personal offers of help. As part of the funding priority "Suicide Prevention (A: Destigmatization)" of the German Federal Ministry of Health, a complex intervention was developed at the University Medical Center Hamburg-Eppendorf. The development and content of this online intervention are described in this article.Following a representative telephone survey of the German general population, which investigated gaps in knowledge and stigmatization tendencies on the subject of suicide, the online intervention "8 lives - lived experience reports and facts on suicide" was developed on the basis of an Australian suicide prevention project and involved persons with a lived experience of suicide. The intervention highlighted both scientific and clinical facts about suicidality as well as a socio-cultural perspective and offered self-help options and professional support services. Video reports of persons with a lived experience of suicide were shown within the intervention. The project is currently being evaluated. A continuation is planned.The intervention is a multi-layered offer in which different perspectives on the topic of suicidality are presented. Participants are addressed on a cognitive and emotional level. Given the prevalence of suicidality and the fact that the subject is still taboo, serious, evidence-based, and low-threshold prevention and information offers seem particularly relevant., (© 2021. The Author(s).)