Effectiveness of Web-based Treatment for Depression in Patients With Neurologic Disorders

Primary Outcome Measures:

• Severity of depressive symptoms [ Time Frame: 7 Days ]
  Severity of depressive symptoms as assessed with the Beck Depression Inventory (BDI)
  
  

Secondary Outcome Measures:

• quality of life [ Time Frame: 14 days ]
  quality of life as assessed by the WHO Quality of Life scale (WHO-QOL BREF)
  
  

Other Outcome Measures:

• depressive symptoms [ Time Frame: 7 days ]
  depressive symptoms as assessed by the Quick Inventory of Depressive Symptomatology (QIDS)
  
  
• core self-evaluations [ Time Frame: 7 days ]
  core self-evaluations as assessed by the Core Self-Evaluations Scale (CSES)
  
  
• suicidal behaviors and tendencies [ Time Frame: 7 days ]
  suicidal behaviors and tendencies as assessed by the Suicidal Behaviors Questionnaire-Revised (SBQ-R)
  
  
• quality of life [ Time Frame: 7 days ]
  quality of life as assessed by the Hamburg MS Quality of Life Questionnaire (HALEMS)
  
  

Deprexis is a web-based intervention that can be obtained online (www.deprexis.com). Deprexis encompasses 10 content modules with a strong focus on evidence-based cognitive-behavioral techniques, either from its so-called first (behavior-oriented), second (cognitive-oriented) or third wave (e.g. mindfulness and acceptance): (1) psychoeducation, (2) behavioral activation, (3) cognitive modification, (4) mindfulness and acceptance, (5) interpersonal skills, (6) relaxation, physical exercise and lifestyle modification, (7) problem solving and (8) expressive writing and forgiveness, (9) positive psychology and (10) dreamwork and emotion-focus interventions. The ten modules are framed by one introductory and one summary module. Communication is carried out online via simulated dialogues. Patients have to respond to narrative text messages from the virtual therapists in multiple-choice response fashion, enabling them to express doubt, to affirm a particular message or to request more information. Text messages are aided with drawings, photographs and animations. The program is adaptive and selects exercises and contents on the basis of the subject's response. The modules are sequential and each module refers and builds upon previous one. Modules can (and should be) repeated within the intervention period.