Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention

Abstract Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6-week guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow-up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results Eighty-five people signed up via the study website, and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression, and hopelessness scores were improved in both groups. Conclusion Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, and careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration Netherlands Trial Register, NTR5028. Registered on 1 March 2015

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Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK: The Feasibility of a Randomised Controlled Trial of a Guided Online Intervention

10.21203/rs.2.24468/v3 ◽

2021 ◽

Author(s):

Ozlem Eylem ◽

Annemieke van Straten ◽

Leonore de Wit ◽

Shanaya Rathod ◽

Kamaldeep Bhui ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Controlled Trial ◽

Intervention Group ◽

Online Intervention ◽

Direct Access ◽

Suicidal Thoughts ◽

Treatment As Usual ◽

Therapeutic Benefits ◽

Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods: Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results: 85 people signed up via the study website and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups. Conclusion: Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

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Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK A Pilot RCT of a guided Online Intervention

10.21203/rs.2.24468/v1 ◽

2020 ◽

Author(s):

Ozlem Eylem ◽

Annemieke van Straten ◽

Leonore de Wit ◽

Shanaya Rathod ◽

Kamaldeep Bhui ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Intervention Group ◽

Online Intervention ◽

Direct Access ◽

Suicidal Thoughts ◽

Treatment As Usual ◽

Turkish Migrants ◽

Therapeutic Benefits ◽

Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines indications for its effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods: Turkish migrants (first and second generation) with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results: A total of 85 people signed up via the study website and 18 (10 intervention, 8 waitlist control) were included. While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups. Conclusion: The online intervention, as might be expected in a small feasibility study, was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

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Reducing Suicidal Ideation among Turkish Migrants in the Netherlands and in the UK: The Feasibility of a Randomised Controlled Trial of a Guided Online Intervention

10.21203/rs.2.24468/v2 ◽

2020 ◽

Author(s):

Ozlem Eylem ◽

Annemieke van Straten ◽

Leonore de Wit ◽

Shanaya Rathod ◽

Kamaldeep Bhui ◽

...

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Controlled Trial ◽

Intervention Group ◽

Online Intervention ◽

Direct Access ◽

Suicidal Thoughts ◽

Treatment As Usual ◽

Therapeutic Benefits ◽

Culturally Adapted

Abstract Background: The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual.Methods: Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6 weeks guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis.Results: 85 people signed up via the study website and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were: not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression and hopelessness scores were improved in both groups.Conclusion: Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not.Trial registration: NTR5028. Registered 1 March 2015, https://www.trialregister.nl/trial/4926

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The relationship between an electronic mental health stigma campaign and suicidal thoughts and behaviours: a two-arm randomized controlled trial in the Australian construction industry

Health Promotion International ◽

10.1093/heapro/daz034 ◽

2019 ◽

Vol 35 (3) ◽

pp. 478-485

Author(s):

A Milner ◽

Z Aitken ◽

P C F Law ◽

A D LaMontagne ◽

C Mann ◽

...

Keyword(s):

Mental Health ◽

Construction Industry ◽

Suicide Ideation ◽

Suicide Attempts ◽

Mental Health Problems ◽

Controlled Trial ◽

Intervention Group ◽

Mental Health Stigma ◽

Post Intervention ◽

Suicidal Thoughts

Abstract Males employed in the construction industry are at greater risk of suicide than other employed males. It is plausible that a high level of stigma against mental health problems explains the elevated rates of suicide among this group. This study sought to test the effectiveness of an electronic mental health stigma intervention on suicide ideation, communication about suicide and attempts. Participants were randomly assigned to receive either a series of brief contact interventions over a 6-week period or a wait list control. Suicidal ideation, communication about suicide and suicide attempts were assessed using the Suicidal Behaviors Questionnaire-Revised at post-intervention. We used linear regression to assess effectiveness at post-intervention, adjusting for relevant covariates using both conventional methods and a propensity score approach. Results indicate that the intervention had no significant impact on suicidal thoughts, communication or suicide attempts. There was some indication that individuals in the intervention group reported a slight increase in attempts and communication about suicide. These observations underscore an urgent need for more research to understand the complex and nuanced relationship between stigma and suicide in non-clinical populations.

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Examining the effect of smoking on suicidal ideation and attempts: triangulation of epidemiological approaches

The British Journal of Psychiatry ◽

10.1192/bjp.2020.68 ◽

2020 ◽

Vol 217 (6) ◽

pp. 701-707 ◽

Cited By ~ 3

Author(s):

Ruth Harrison ◽

Marcus R. Munafò ◽

George Davey Smith ◽

Robyn E. Wootton

Keyword(s):

Suicidal Ideation ◽

Odds Ratio ◽

Suicide Attempts ◽

Causal Effect ◽

Smoking Status ◽

Strong Association ◽

Mendelian Randomisation ◽

Polymorphism Analysis ◽

Suicidal Thoughts ◽

Smoking Behaviours

BackgroundPrevious literature has demonstrated a strong association between cigarette smoking, suicidal ideation and suicide attempts. This association has not previously been examined in a causal inference framework and could have important implications for suicide prevention strategies.AimsWe aimed to examine the evidence for an association between smoking behaviours (initiation, smoking status, heaviness, lifetime smoking) and suicidal thoughts or attempts by triangulating across observational and Mendelian randomisation analyses.MethodFirst, in the UK Biobank, we calculated observed associations between smoking behaviours and suicidal thoughts or attempts. Second, we used Mendelian randomisation to explore the relationship between smoking and suicide attempts and ideation, using genetic variants as instruments to reduce bias from residual confounding and reverse causation.ResultsOur observational analysis showed a relationship between smoking behaviour, suicidal ideation and attempts, particularly between smoking initiation and suicide attempts (odds ratio, 2.07; 95% CI 1.91–2.26; P < 0.001). The Mendelian randomisation analysis and single-nucleotide polymorphism analysis, however, did not support this (odds ratio for lifetime smoking on suicidal ideation, 0.050; 95% CI −0.027 to 0.127; odds ratio on suicide attempts, 0.053; 95% CI, −0.003 to 0.110). Despite past literature showing a positive dose-response relationship, our results showed no clear evidence for a causal effect of smoking on suicidal ideation or attempts.ConclusionsThis was the first Mendelian randomisation study to explore the effect of smoking on suicidal ideation and attempts. Our results suggest that, despite observed associations, there is no clear evidence for a causal effect.

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Probiotics Effect on Interleukin-4 (IL-4) and Imunoglobulin E (IgE) Levels on Asthmatic Patients

Sains Medika ◽

10.26532/sainsmed.v6i2.604 ◽

2016 ◽

Vol 6 (2) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

Pujiati Pujiati

Keyword(s):

Serum Level ◽

Childhood Asthma ◽

Immunoglobulin E ◽

Controlled Trial ◽

Intervention Group ◽

Serum Levels ◽

Interleukin 4 ◽

Control Group ◽

Asthmatic Patients ◽

Therapeutic Benefits

Introduction: Probiotics may play a role in immune system maturation and may reduce the risk of allergies and asthma in childhood. However, the therapeutic benefits of probiotics in asthma depend on various factors such as strain of probiotics and dosing regimen. Objectives: The aims of this study was to evaluate the effect of probiotic (LactoB®) on Immunoglobulin E (IgE) and Interleukin (IL-4) serum level in childhood Asthma. Methods: Forty children aged 1-5 years with asthma were recruited into a randomized controlled trial. The children were assigned into a probiotic (Lactobacillus acidophilus, Bifidobacterium longun, Streptococcus; Lacto B®) or an equivalent volume of placebo, twice daily orally for 8 weeks. The IgE and IL-4 serum level were determined by ELISA. The differences between groups were analyzed by t-test dependent with confidence interval of 95%. Results: In intervention group, mean of IgE serum levels after the probiotics treatment was significantly lower compared to that of before the treatment (148.18 pg/mg; 283.20 pg/mg; respectively). Mean of IL-4 serum levels after the treatment was significantly lower compared with that of before the treatment (111.03 pg/mg; 142.08 pg/mg respectively). In control group, there were no significant differences between IgE serum levels mean before the administration of placebo and after the intervention (292.39 pg/ml; 286.94 pg/ml respectively). There were no significant differences between IL-4 serum levels mean before and after the treatment (136.76 pg/ml; 139.56 pg/ml).Conclusion: there was an effect of probiotics supplementation on IgE and IL-4 serum levels in childhood asthma.

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Methods and efficacy of social support interventions in preventing suicide: a systematic review and meta-analysis

Evidence-Based Mental Health ◽

10.1136/ebmental-2021-300318 ◽

2021 ◽

pp. ebmental-2021-300318

Author(s):

Xiaofei Hou ◽

Jiali Wang ◽

Jing Guo ◽

Xinxu Zhang ◽

Jiahai Liu ◽

...

Keyword(s):

Social Support ◽

Clinical Trials ◽

Suicide Attempts ◽

Controlled Trial ◽

Meta Analysis ◽

Intervention Group ◽

Inclusion Criteria ◽

Support Providers ◽

Study Selection ◽

Randomised Controlled

QuestionSuicide is a global public and mental health problem. The effectiveness of social support interventions has not been widely demonstrated in the prevention of suicide. We aimed to describe the methods of social support interventions in preventing suicide and examine the efficacy of them.Study selection and analysisWe searched literature databases and conducted clinical trials. The inclusion criteria for the summary of intervention methods were as follows: (1) studies aimed at preventing suicide through method(s) that directly provide social support; (2) use of one or more method(s) to directly provide social support. The additional inclusion criteria for meta-analysis on the efficacy of these interventions included: (1) suicide, suicide attempt or social support-related outcome was measured; (2) randomised controlled trial design and (3) using social support intervention as the main/only method.FindingsIn total, 22 656 records and 185 clinical trials were identified. We reviewed 77 studies in terms of intervention methods, settings, support providers and support recipients. There was a total of 18 799 person-years among the ten studies measuring suicide. The number of suicides was significantly reduced in the intervention group (risk ratio (RR)=0.48, 95% CI 0.27 to 0.85). In 14 studies with a total of 14 469 person-years, there was no significant reduction of suicide attempts in the overall pooled RR of 0.88 (95% CI 0.73 to 1.07).ConclusionsSocial support interventions were recommended as a suicide prevention strategy for those with elevated suicide risk.

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The effectiveness of an online intervention in stimulating injury-preventive behaviour in adult novice runners. Results of a randomised controlled trial.

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2021/v33i1a11297 ◽

2021 ◽

Vol 33 (1) ◽

pp. 1-9

Author(s):

Ellen Kemler ◽

Maaike Cornelissen ◽

Vincent Gouttebarge

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Online Intervention ◽

Control Group ◽

Warm Up ◽

Training Schedule ◽

Strength Exercises ◽

Preventive Behaviour ◽

Randomised Controlled

Background: The online intervention Runfitcheck was developed to stimulate injury-preventive behaviour among adult novice runners. Objective: The objective of this study was to evaluate the effectiveness of Runfitcheck on injury-preventive behaviour among adult novice runners. Material and methods: A randomised controlled trial was conducted among adult novice runners. The intervention group had access to the Runfitcheck intervention, the control group performed their running activities as usual. One, three, and five months after enrolment, participants reported retrospectively what they had done regarding injury-preventive behaviour (operationalised as (i) using a (personalised) training schedule; (ii) performing strength and technique exercises; and (iii) performing a warm-up routine prior to running). Relative Risks (RR) and 95% Confidence Interval (95%CI) were used to analyse behavioural change. Results: The intervention group (n=715) searched more often for information about a warm-up routine (RR 1.211; 95%CI 1.080-1.357), added more often strength exercises to their warm-up routine ( RR 1.228; 95%CI 1.092-1.380). The intervention group performed more often running technique exercises compared to the control group (n=696) (RR 1.134; 95%CI 1.015-1.267), but less often strength exercises (RR 0.865 (95%CI 0.752-0.995). Within the group of runners that did not perform any warm-up routine at enrolment (n=272), the intervention group performed a regular warm-up routine more often than the control group (RR 1.461; 95%CI 1.084-1.968) No significant results were found for using a training schedule. Discussion and conclusion: The online intervention Runfitcheck was effective in stimulating aspects of injury-preventive behaviour in adult novice runners, mostly related to a warm-up routine.

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The effectiveness of an online intervention in stimulating injury-preventive behaviour in adult novice runners. Results of a randomised controlled trial.

10.21203/rs.3.rs-22177/v1 ◽

2020 ◽

Author(s):

Ellen Kemler ◽

Maaike H. Cornelissen ◽

Vincent Gouttebarge

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Intervention Group ◽

Online Intervention ◽

Control Group ◽

Warm Up ◽

Training Schedule ◽

Strength Exercises ◽

Preventive Behaviour ◽

Randomised Controlled

Abstract Background In addition to the beneficial health effects of being active, running is also associated with a risk of sustaining injuries. The online intervention Runfitcheck was developed to stimulate injury-preventive behaviour among adult novice runners. The objective of this study was to evaluate the effectiveness of Runfitcheck on injury-preventive behaviour among adult novice runners. Design Randomised controlled trial Methods A randomised controlled trial with a follow-up period of five months was conducted among adult novice runners. The intervention group had access to the Runfitcheck intervention, while the control group performed their running activities as usual. One, three, and five months after enrolment, participants reported retrospectively what they had done regarding injury-preventive behaviour (operationalised as (i) using a (personalised) training schedule; (ii) performing strength and technique exercises; and (iii) performing a warm-up routine prior to running). Relative Risks ((RR) and 95% Confidence Interval (95%CI)) were used to analyse behavioural change among runners who were not performing the favourable behaviour at enrolment. Results A total of 1,411 novice runners (72.6% female, mean age 38.1 years) were included in this study and assigned to the intervention group (n=715) or control group (n=696). Runners in the intervention group searched more often for information about a warm-up routine (55.6% versus 44.9%; RR 1.211 (95%CI 1.080-1.357); Table 2), and added more often strength exercises to their warm-up routine (49.3% versus 38.2%; RR 1.228 (95%CI 1.092-1.380)). Runners in the intervention group performed more often running technique exercises compared to runners in the control group (58.6% versus 51.5%; RR 1.134 (95%CI 1.015-1.267)), but less often strength exercises (71.9% versus 77.9%; RR 0.865 (95%CI 0.752-0.995)). Within the group of runners that did not perform any warm-up routine at enrolment (n=272; 69.5% female, mean age 35.8 years (SD 9.3), runners in the intervention group performed a regular warm-up routine more often than runners in the control group (47.1% versus 28.4%; n=196; RR 1.461 (95%CI 1.084-1.968)) No significant results were found for using a training schedule. Conclusions The online intervention Runfitcheck was effective in stimulating aspects of injury-preventive behaviour in adult novice runners, mostly related to a warm-up routine.

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Efficacy of an online intervention for treatment of depressive disorders: a three-arm randomized controlled trial comparing guided and unguided self-help with waitlist control (Preprint)

10.2196/preprints.34028 ◽

2021 ◽

Author(s):

Krämer Rico

Keyword(s):

Depressive Symptoms ◽

Depressive Disorders ◽

Depressive Symptomatology ◽

Controlled Trial ◽

Intervention Group ◽

Online Intervention ◽

Self Report ◽

Secondary Outcome ◽

Control Group

BACKGROUND Digital health applications are efficacious treatment options for mild-to-moderate depressive disorders. However, the extent to which psychological guidance increases the efficacy of these applications is controversial. OBJECTIVE We evaluated the efficacy of the online intervention “Selfapy” for unipolar depression. We also investigated differences between a psychotherapist-guided vs. unguided version compared with those from a control group. METHODS A cohort of 401 participants with mild-to-severe depressive disorders were assigned randomly to either participate in a guided version of Selfapy (involving weekly telephone calls of 25-min duration), an unguided version of Selfapy, or to the waiting list (control group). Selfapy is a cognitive behavioral therapy-based intervention for depressive disorders of duration 12 weeks. Symptom assessment was undertaken at T1 (before study entrance), T2 (after 6 weeks), T3 (post-treatment, after 12 weeks), and T4 (follow-up, after 6 months). The main outcome was reduction in depressive symptoms in the Beck Depression Inventory (BDI-II) from T1 to T3. Secondary-outcome parameters were the Quick Inventory of Depressive Symptomatology – Self Report (QIDS-SR 16) and Beck Anxiety Inventory (BAI). RESULTS A total of 297 out of 401 participants (74.06%) completed the post-measurement at T3. In the primary analysis, both intervention groups showed a significantly higher reduction in depressive symptoms (BDI-II) from T1 to T3 compared with that in the control group, with high within-effect sizes (guided: d = 1.46; unguided d = 1.36). No significant differences were found for guided vs. unguided treatment groups. The response rate (BDI-II) for intention-to-treat data in the guided version was 46.4%, 40.0% for the unguided version, and 2.0% in the control group. After 6 months (T4), treatment effects could been maintained for both intervention groups (BDI-II) without differences between either intervention group. CONCLUSIONS Conclusions: Selfapy can help to reduce depressive symptoms in guided or unguided version. Follow-up data suggest that these effects could be maintained. The guided version was not superior to the unguided version. CLINICALTRIAL Trial Registration: Current Controlled Trial DRKS00017191 Date of registration: 14 May 2019 INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1186/s13063-021-05218-4

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