The new internet generation: iCBT treatment for seniors with mild-moderate depression - a pragmatic randomised controlled trial in the primary care context

The purpose of this study is to evaluate the effectiveness of internet cognitive behavioural therapy (iCBT) for elderly patients with mild/moderate depression in comparison to treatment-as-usual at the primary care centre (PCC).

Is iCBT treatment of depression in persons aged >65 as effective as care as usual in terms of depressive symptoms, quality-of-life, and function?

The study will be accomplished via a randomized controlled trial of two groups (intervention and control) in the primary care setting and carried through by a project organisation consisting of several primary care and general practice clinical and research competences, in collaboration with psychiatry, psychology and health informatics.

Follow up at 3 and 6 months.All patients >65 seeking care at the PCCs and diagnosed with mild/moderate depressive symptoms will be randomised to a 12-week iCBT depression program or to depression care-as-usual at the PCC in accordance with Swedish national guidelines. Primary outcome: reduction of depressive symptoms.

Secondary outcomes: quality-of-life, work ability, relationships, activities of daily living and social participation.

Statistical analysis will be mixed model with repeated measures comparing 3 and 6 month means, intervention vs control.If iCBT is shown effective for depression in persons >65, this would imply a higher accessibility to evidence-based iCBT treatment also for more senior patients in primary care and facilitate nation wide implementation.