Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial.

BACKGROUND Preliminary results have demonstrated the clinical efficacy of computerised cognitive-behavioural therapy (CBT) in the treatment of anxiety and depression in primary care. AIMS To determine, in an expanded sample, the dependence of the efficacy of this therapy upon clinical and demographic variables. METHOD A sample of 274 patients with anxiety and/or depression were randomly allocated to receive, with or without medication, computerised CBT or treatment as usual, with follow-up assessment at 6 months. RESULTS The computerised therapy improved depression, negative attributional style, work and social adjustment, without interaction with drug treatment, duration of preexisting illness or severity of existing illness. For anxiety and positive attributional style, treatment interacted with severity such that computerised therapy did better than usual treatment for more disturbed patients. Computerised therapy also led to greater satisfaction with treatment. CONCLUSIONS Computer-delivered CBT is a widely applicable treatment for anxiety and/or depression in general practice.