Trial Explores Using Internet to Treat Mood and Anxiety Disorders

By Cristina Mestre

A new project is looking at how the Internet might play a role in helping patients with depression and/or anxiety. If proven effective, this innovative approach could have a significant impact on the treatment of depression and anxiety in primary care, where the majority of patients with these conditions seek help.

Thousands of websites provide general health and disease-specific information, and the number of Internet support groups (ISGs) where the public can actively exchange information about treatments is growing as the costs to develop these systems has continued to drop. Some health-related sites have evolved into large-scale information sharing sites with thousands of members organized into numerous disease-specific ISGs, such as the site PatientsLikeMeor the use of social media by diabetes patients as reported by NPR.  These sites permit members to share treatment and symptom information and provide peer-support using a variety of online tools.

Aware of the latest advances in “e-mental health," the University of Pittsburgh School of Medicine’s Bruce L. Rollman, M.D.,M.P.H., received a $2.6M grant from the National Institute of Mental Health (NIMH) to test the comparative-effectiveness of combining an ISG with Beating the Blues, the online computerized cognitive behavioral therapy (CCBT) program presently being deployed by UPMC.

The NIMH-funded Online Treatment for Mood and Anxiety Disorders Trial is presently enrolling depressed and anxious patients aged 18 to 75 from 22 UPMC-affiliated primary care offices across western Pennsylvania.  Eligible patients referred by their UPMC primary care physician to the trial may be randomized to the ISG where they can access discussion boards and other treatment resources, communicate with other study patients, and use the CCBT program under the direction of a study care manager.  Co-investigator and psychiatrist Jordan Karp, M.D., associate professor of Psychiatry, is an active presence on the ISG along with care manager and ISG moderator Chris Wiltrout, B.S.

Other ISG features  available for trial participants include:

• An extensive list of national and local resources for depression and anxiety.
• RSS feeds on the latest consumer mental health information.
• Direct access to UPMC HealthTrak and the Beating the Blues program.
• A mobile version which allows patients with smartphones to take the ISG with them wherever they go.

Although the leading ISGs today are independent of any organized health care delivery system such as UPMC, Dr. Rollman anticipates these technologies will soon be “branded” and deployed by health care organizations experimenting with social media.  Still, few randomized trials have evaluated the psychologic benefits of ISGs, and none were linked to patients’ routine source of primary care or any other organized health care delivery system as the Online Treatment for Mood and Anxiety Disorders Trial is evaluating.  

If ISGs are proven effective and cost-effective, Dr. Rollman believes they will be widely adopted throughout the U.S. to improve patient care for many other health conditions.