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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Depression Awareness and Self-Management Through the Internet: Protocol for an Internationally Standardized Approach
Author(s): Arensman, Ella
Koburger, Nicole
Larkin, Celine
Karwig, Gillian
Coffey, Claire
Maxwell, Margaret
Harris, Fiona
Rummel-Kluge, Christine
van Audenhove, Chantal
Sisask, Merike
Alexandrova-Karamanova, Anna
Perez, Victor
Purebl, Gyorgy
Cebria, Annabel
Palao, Diego
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Keywords: cognitive behavioral therapy
primary care
Issue Date: 30-Sep-2015
Date Deposited: 7-Aug-2015
Citation: Arensman E, Koburger N, Larkin C, Karwig G, Coffey C, Maxwell M, Harris F, Rummel-Kluge C, van Audenhove C, Sisask M, Alexandrova-Karamanova A, Perez V, Purebl G, Cebria A & Palao D (2015) Depression Awareness and Self-Management Through the Internet: Protocol for an Internationally Standardized Approach. JMIR Research Protocols, 4 (3), Art. No.: e99.
Abstract: Background: Depression incurs significant morbidity and confers increased risk of suicide. Many individuals experiencing depression remain untreated due to systemic and personal barriers to care. Guided Internet-based psychotherapeutic programs represent a promising means of overcoming such barriers and increasing the capacity for self-management of depression. However, existing programs tend to be available only in English and can be expensive to access. Furthermore, despite evidence of the effectiveness of a number of Internet-based programs, there is limited evidence regarding both the acceptability of such programs and feasibility of their use, for users and health care professionals. Objective: This paper will present the protocol for the development, implementation, and evaluation of the iFightDepression tool, an Internet-based self-management tool. This is a cost-free, multilingual, guided, self-management program for mild to moderate depression cases. Methods: The Preventing Depression and Improving Awareness through Networking in the European Union consortium undertook a comprehensive systematic review of the available evidence regarding computerized cognitive behavior therapy in addition to a consensus process involving mental health experts and service users to inform the development of the iFightDepression tool. The tool was implemented and evaluated for acceptability and feasibility of its use in a pilot phase in 5 European regions, with recruitment of users occurring through general practitioners and health care professionals who participated in a standardizedtraining program. Results: Targeting mild to moderate depression, the iFightDepression tool is based on cognitive behavioral therapy and addresses behavioral activation (monitoring and planning daily activities), cognitive restructuring (identifying and challenging unhelpful thoughts), sleep regulation, mood monitoring, and healthy lifestyle habits. There is also a tailored version of the tool for young people, incorporating less formal language and additional age-appropriate modules on relationships and social anxiety. The tool is accompanied by a 3-hour training intervention for health care professionals. Conclusions: It is intended that the iFightDepression tool and associated training for health care professionals will represent a valuable resource for the management of depression that will complement existing resources for health care professionals. It is also intended that the iFightDepression tool and training will represent an additional resource within a multifaceted approach to improving the care of depression and preventing suicidal behavior in Europe.
DOI Link: 10.2196/resprot.4358
Rights: ©Ella Arensman, Nicole Koburger, Celine Larkin, Gillian Karwig, Claire Coffey, Margaret Maxwell, Fiona Harris, Christine Rummel-Kluge, Chantal van Audenhove, Merike Sisask, Anna Alexandrova-Karamanova, Victor Perez, György Purebl, Annabel Cebria, Diego Palao, Susana Costa, Lauraliisa Mark, Mónika Ditta Tóth, Marieta Gecheva, Angela Ibelshäuser, Ricardo Gusmão, Ulrich Hegerl. Originally published in JMIR Research Protocols (, 06.08.2015. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included
Notes: Additional co-authors: Susana Costa; Lauraliisa Mark; Mónika Ditta Tóth; Marieta Gecheva; Angela Ibelshäuser; Ricardo Gusmão; Ulrich Hegerl
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