JMIR Publications

ABSTRACT

Background:

In Turkey, there are serious deficiencies in mental health care. Among these, undertreatment of mentally ill patients, lack of psychologists and inadequate psychosocial and rehabilitation options for patients and their relatives are important prohibiting factors that reduce patients’ outreach for getting help. While depression is highly prevalent (4.4%), only a small number of people seek professional help (18%) in Turkey. Innovative solutions are needed to overcome this treatment gap. Online Problem-Solving Therapy (PST) is a brief intervention proven to be effective in the treatment of depression, although little is known about its clinical effects in Turkey.

Objective:

The aim of this study is to test the clinical effects of a web and mobile application of PST for depressive symptoms among the general population in Turkey.

Methods:

Participants will be recruited through announcements in social media and the Middle East Technical University. Adults (aged 18-55 years) with mild to moderate depressive symptoms (Beck Depression Inventory-II score between 10-29) will be included in the study. Participants with a medium-to-high suicidal risk (according to the MINI-International Neuropsychiatric Interview) will be excluded. A randomized controlled trial with a sample size of 444 participants randomized across three groups will be utilized. The first experimental group will receive direct access to the web version of the intervention; the second experimental group will receive direct access to the mobile app of the intervention as well as automated supportive text messages based on PST. The control group consists of a wait-list and for ethical reasons, participants in this group will gain access to the intervention (either web or mobile application) four months after the baseline. The intervention is based on an existing PST for the Turkish population, Her Şey Kontrol Altında (HŞKA), and is guided by a clinical psychologist. The primary outcome is change in depressive symptoms. Secondary outcomes include symptoms of anxiety, stress, worry, self-efficacy, quality of life. Furthermore, satisfaction with the intervention, usability and acceptability of the intervention are important features that will be evaluated. All outcomes will take place online trough self-assessment.

Results:

Results from this study will reveal more information about the clinical effects of HŞKA, as well as its applicability in a Turkish setting through the web and mobile platforms.

Conclusions:

Based on the results, online guided PST intervention might become an appropriate alternative for treating mild to moderate depressive symptoms. Clinical Trial: ClinicalTrials.gov NCT03754829; https://clinicaltrials.gov/ct2/show/NCT03754829; (Archived by WebCite at http://www.webcitation.org/74HugwLo7)