A Randomized Controlled Trial of Deprexis; Evaluation of A Computerized Intervention to Decrease Depression and Restore Functioning in Veterans

Depressive symptoms are highly prevalent among post-deployment Veterans, and the associated morbidity and mortality is excessively high. Although patient preference studies indicate that those with depressive symptoms prefer psychotherapy over medication treatment, numerous person-specific, interpersonal and system-level barriers can prevent Veterans with depressive symptoms from accessing adequate psychotherapy. Internet-delivered interventions, which are lower threshold, shows promise for the treatment of depressive symptoms in the general population. Although internet-delivered interventions have the potential to optimize treatment access and utilization for those with a recent onset of depressive symptoms, there is limited evidence supporting their effectiveness in Veterans. Deprexis is a computerized intervention, which employs interpersonal, cognitive-behavioral and third wave behavioral treatment techniques to target depressive symptoms and related functional impairments. Dr. Beevers (co-mentor) previously demonstrated that Deprexis improved well-being, and decreased depressive symptoms and disability in a general population sample. Dr. Pearson then used machine-learning statistical methods to identify predictors of Deprexis treatment response, with results indicating that Deprexis was most beneficial for those with mild to moderate symptoms of depression. In the proposed study qualitative interviews will be conducted to gain insight into Veterans’ perceptions, needs, and preferences vis-a-vis Deprexis, with results informing a randomized controlled trial. Here an 8-week course of Deprexis will be compared to a treatment-as-usual control condition to establish if results obtained in the general population sample extend to Veterans with mild to moderate depressive symptoms. The results of this work could have a profound impact on Veterans’ functional recovery by broadening the reach and timeliness of psychological interventions for depressive symptoms. Our long-term vision is that Deprexis can be integrated in a stepped-care approach; providing rapid intervention for individuals with mild to moderate depressive symptoms, while reserving resource-intensive treatments such as face-to-face psychotherapy for individuals with severe symptomatology.