Depression: Blacks benefit more from computerized CBT, but are less likely to use it

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Takeaway

  • Compared with Whites, African Americans were less likely to engage in computerized cognitive behavioral therapy (CCBT) for depression and anxiety, but those who did use it benefitted more than Whites.

Why this matters

  • African Americans may be at greater risk for depression, and are less likely to pursue treatment. The results suggest CCBT is effective in African Americans but needs to be optimized to improve participation.

Study design

  • The researchers randomly assigned 704 patients to a CCBT-only group (Beating the Blues program with 24/7 patient access), CCBT plus an internet support group, or usual care.
  • Funding: The National Institute of Mental Health and the Agency for Healthcare Research and Quality.

Key results

  • 75% of African Americans started session 1 of the CCBT program compared with 87% of Whites (P=.01), and also completed fewer sessions at 6 mo (4.7 vs 5.5; P=.03).
  • As assessed by the 9-item Patient Health Questionnaire, African Americans benefited more than Whites with respect to depressive symptoms (estimated 8-session change, −6.6 vs −5.5; P=.06), and gained similar benefit with respect to anxiety symptoms (−5.3 vs −5.6; P=.80).

Limitations

  • The study was regionally limited, having been conducted in Pennsylvania.