The efficacy of feedback after depression screening. A web-based randomized controlled trial

• Applicants: Dr. Sebastian Kohlmann; Professor Dr. Hans-Helmut König; Professor Dr. Bernd Löwe; Professor Dr. Karl Wegscheider
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine ; Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: from 2019 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 424162019

Depressive disorders are amongst the most significant clinical disorders with respect to prevalence (lifetime prevalence: approx. 11%) and disability (approx. 8 years lived with disability). Yet, current evidence suggests that depressive disorders are under-recognized, diagnosed incorrectly and, thus, often remain untreated. In turn, this leads to increased disease burden. To directly address this disease burden, there is an urgent need to efficiently target depression severity with early detection interventions that reach affected individuals. Seeking for information on depression affected individuals often consult the internet first. Therefore, a web-based screening could efficiently address affected but undetected individuals. Yet, systematic reviews and meta-analyses conclude that depression screening – per se – is not effective to decrease depression severity. However, direct feedback to patients in addition to depression screening leads to decreased depression severity in cardiac patients. This is the result of our randomized controlled trial (RCT) – the DEPSCREEN-INFO trial. Of note, a) the patient feedback intervention was compared to physician feedback, b) the effect was significant even after six months and c) the intervention was likely to be cost-effective. Based on our promising results, we aim to answer the research question whether this minimal complex feedback intervention is also effective as a web-based intervention. To tie on our findings and combine them with recent advantages in depression care, we aim to maximize the efficacy of the feedback intervention by applying a personalized medicine approach.The here proposed three arm observer-blinded RCT will test the efficacy of a web-based feedback intervention in individuals at risk for depression. Via a study website participants will be recruited. Individuals (n=699) with increased depression severity will receive either a) depression screening only, or b) depression screening plus standardized feedback, or c) depression screening plus personalized feedback. We assume that both feedback interventions are more effective in decreasing depression severity after 6 months than depression screening only (primary hypothesis) and that personalized feedback is more effective than non-personalized feedback (secondary hypothesis). A further secondary analysis will also test the cost-effectiveness. Additionally, the trial will identify the potential harms and benefits of web-based depression screening and determine the value of personalized feedback for early detection of depression.

• DFG Programme: Research Grants