Claudia Buntrock

Claudia Buntrock
Friedrich-Alexander-University of Erlangen-Nürnberg | FAU · Department of Clinical Psychology and Psychotherapy

PhD

About

59
Publications
17,686
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1,727
Citations
Introduction
Evaluating the efficacy and cost-effectiveness of web-based indicated prevention of major depression
Additional affiliations
December 2017 - present
Friedrich-Alexander-University of Erlangen-Nürnberg
Position
  • PostDoc Position
October 2016 - November 2017
Friedrich-Alexander-University of Erlangen-Nürnberg
Position
  • PhD Student
January 2015 - December 2015
Vrije Universiteit Amsterdam
Position
  • PhD Student

Publications

Publications (59)
Article
Full-text available
Introduction It is unclear how internet-delivered cognitive-behavioural therapy for insomnia (CBT-I) can be integrated into healthcare systems, and little is known about the optimal level of therapist guidance. The aim of this study is to investigate three different versions of a stepped care model for insomnia (IG1, IG2, IG3) versus treatment as u...
Article
Full-text available
Aims: To perform an economic evaluation of guided and unguided internet-based interventions to reduce problematic alcohol consumption in employees compared with a waitlist control condition (WLC) with unrestricted access to treatment-as-usual. Design: A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) from a societal and a cost-...
Article
Background The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I’s health-economic effects. Objective This study aimed to evaluate the cost-effectiveness and cost–utility of iCBT-I in reducing insomnia among schoolteachers. Methods Schoolteachers (N=128) with clinica...
Article
Background Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. Methods We did a systematic revi...
Article
Full-text available
Introduction: Internet- and mobile-based interventions (IMIs) and their integration into routine psychotherapy (i.e., blended therapy) can offer a means of complementing psychotherapy in a flexible and resource optimized way. Objective: The present study will evaluate the non-inferiority, cost-effectiveness, and safety of two versions of integrated...
Article
Background: Quality-adjusted life years (QALYs) are widely used to measure the impact of various diseases on both the quality and quantity of life and in their economic valuations. It will be clinically important and informative if we can estimate QALYs based on measurements of depression severity. Objective: To construct a conversion table from t...
Article
Full-text available
Background Quality-adjusted life years (QALYs) are widely used to measure the impact of various diseases on both the quality and quantity of life and in their economic valuations. It will be clinically important and informative if we can estimate QALYs based on measurements of depression severity. Objective To construct a conversion table from the...
Article
Full-text available
Despite the high prevalence of comorbid depression in people living with coronary artery disease (CAD), uptake of psychological treatment is generally low. This study was designed to investigate the feasibility of an internet-based cognitive-behavioral (iCBT) depression intervention for people with CAD and depressive symptoms. Methods: People wit...
Article
Full-text available
Background: There is a high demand for evidence-based and cost-effective treatment concepts for convicted individuals who sexually abused children (ISAC) and individuals who consumed child sexual exploitation material (ICCSEM) under community supervision (CS). The @myTabu-consortium developed a guided web-based intervention for convicted ISAC and I...
Article
The efficacy of Internet- and mobile-based interventions (IMIs) for depression in adults is well established. Yet, comprehensive knowledge on the mediators responsible for therapeutic change in these interventions is pending. Therefore, we conducted the first systematic review on mediators in IMIs for depression, investigating mechanisms of change...
Preprint
BACKGROUND The evidence base for internet-based cognitive behavioral therapy for insomnia (iCBT-I) is firm; however, little is known about iCBT-I’s health-economic effects. OBJECTIVE This study aimed to evaluate the cost-effectiveness and cost–utility of iCBT-I in reducing insomnia among schoolteachers. METHODS Schoolteachers (N=128) with clinica...
Article
The aim of this study was to assess the available evidence on potential moderators of psychological and psychoeducational interventions for the prevention of anxiety. A systematic review using PubMed, PsycINFO, Web of Science, Embase, OpenGrey, and CENTRAL was performed up to October 2019. Two independent researchers assessed the fulfillment of eli...
Article
Full-text available
Introduction: Chronic pain is highly prevalent, associated with substantial personal and economic burdens, and increased risk for mental disorders. Individuals in green professions (agriculturists, horticulturists, foresters) show increased prevalence of chronic pain and other risk factors for mental disorders. Available healthcare services in rur...
Article
Full-text available
Introduction: Evidence on effects of Internet-based interventions to treat subthreshold depression (sD) and prevent the onset of major depression (MDD) is inconsistent. Objective: We conducted an individual participant data meta-analysis to determine differences between intervention and control groups (IG, CG) in depressive symptom severity (DSS...
Article
Importance Depression is a frequent comorbid condition in patients with persistent back pain and is associated with substantial adverse consequences, including the risk of developing opioid use disorders. Shifting the focus from depression treatment to preventing depression might be a viable way to reduce the disease burden. Objective To evaluate...
Article
Psychological and psychoeducational interventions have proven to be effective in preventing depression. However, the identification of the patients that benefit the most from each type of intervention has not yet been established. A systematic review was performed of the literature on moderators of preventive psychological and psychoeducational int...
Article
Full-text available
Background Chronic back pain (CBP) is linked to a higher prevalence and higher occurrence of major depressive disorder (MDD) and can lead to reduced quality of life. Unfortunately, individuals with both CBP and recurrent MDD are underidentified. Utilizing health care insurance data may provide a possibility to better identify this complex populatio...
Article
Full-text available
Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters, and gardeners (SVLFG) to implement internet- and tele-based services among others to improve mental health in this p...
Preprint
Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters and gardeners (SVLFG ) to implement internet- and tele-based services among others to improve mental health in this p...
Article
Full-text available
Background: People in green professions are exposed to a variety of risk factors, which could possibly enhance the development of depression. Amongst possible prevention approaches, internet- and mobile-based interventions (IMIs) have been shown to be effective and scalable. However, little is known about the effectiveness in green professions. Th...
Article
Full-text available
Background: Substance use disorders (SUDs) contribute significantly to global rates of morbidity and mortality. Internet- and mobile-based interventions (IMIs) have been suggested as an adjunct to face-to-face health services. However, the evidence for the cost-effectiveness of IMIs for SUDs is scant. Methods: A comprehensive literature search i...
Article
Full-text available
Introduction: Diabetes mellitus type 1 and type 2 are linked to higher prevalence and occurrences of depression. Internet-based depression- and diabetes-specific cognitive behavioral therapies (CBT) can be effective in reducing depressive symptom severity and diabetes-related emotional distress. The aim of the study was to test whether disease-spe...
Article
Full-text available
1 Background Major depressive disorder (MDD) in college students is associated with substantial burden. 2 Aims To assess 1‐year incidence of MDD among incoming freshmen and predictors of MDD‐incidence in a representative sample of students. 3 Method Prospective cohort study of first‐year college students (baseline: n = 2,519, 1‐year follow‐up: n...
Article
Full-text available
Objective This study aims at evaluating the cost-effectiveness and cost-utility of a guided and unguided internet-based intervention for chronic pain patients (ACTonPain guided and ACTonPain unguided ) compared with a waitlist control group (CG) as well as the comparative cost-effectiveness of the guided and the unguided version. Design This is a...
Article
Full-text available
Objectives: Mental disorders are frequent, associated with disability-adjusted life years, societal, and economic costs. Children of parents with a mental illness (COPMI) are at an increased risk to develop disorders themselves. The transgenerational transmission of mental disorders has been conceptualized in a model that takes parental and family...
Article
Full-text available
Background: Mental health problems are highly frequent, as well as being associated with enormous societal and economic costs and significant disability-adjusted life years. Children of parents with a mental illness (COPMI) are at a tremendously increased risk to develop disorders themselves. According to the literature, parental mental disorders l...
Preprint
BACKGROUND Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. OBJECTIVE The aim of this study was to assess the cost-effectiveness of a guided iSMI...
Article
Full-text available
Background: Work-related stress is widespread among employees and associated with high costs for German society. Internet-based stress management interventions (iSMIs) are effective in reducing such stress. However, evidence for their cost-effectiveness is scant. Objective: The aim of this study was to assess the cost-effectiveness of a guided i...
Article
Background Web-based interventions are effective in reducing depression. However, the evidence for the cost-effectiveness of these interventions is scarce. Aims The aim is to assess the cost-effectiveness of a web-based intervention (GET.ON M.E.D.) for individuals with diabetes and comorbid depression compared with an active control group receivin...
Article
Full-text available
Introduction: The long-term effectiveness of psychological interventions for the treatment of subthreshold depression and the prevention of depression is unclear and effects vary among subgroups of patients, indicating that not all patients profit from such interventions. Randomised clinical trials are mostly underpowered to examine adequately sub...
Data
PRISMA‐IPD Checklist of items to include when reporting a systematic review and meta‐analysis of individual participant data (IPD)
Article
Full-text available
Background Mental health problems are common and place a burden on the individual as well as on societal resources. Despite the existence of evidence-based treatments, access to treatment is often prevented or delayed due to insufficient health care resources. Effective internet-based self-help interventions have the potential to reduce the risk fo...
Article
Full-text available
Background There is limited evidence on the cost effectiveness of Internet-based treatments for depression. The aim was to evaluate the cost effectiveness of guided Internet-based interventions for depression compared to controls. Methods Individual–participant data from five randomized controlled trials (RCT), including 1,426 participants, were c...
Article
Full-text available
Background: Many individuals engaging in Internet-based interventions fail to complete these treatments as intended. The processes responsible for treatment adherence in Internet-based interventions are still poorly understood. Objective: The aim of this study was to investigate to what extent adherence in an Internet-based intervention can be p...
Article
Full-text available
Objective This study aimed to estimate and evaluate the cost-effectiveness and cost-benefit of a guided internet- and mobile-supported occupational stress-management intervention (iSMI) for employees from the employer's perspective alongside a randomized controlled trial. Methods A sample of 264 employees with elevated symptoms of perceived stress...
Presentation
Introduction: Internet-based interventions have shown to be effective for a wide range of mental health conditions. However, while studies have demonstrated the positive effects of internet-based guided self-help, little is known about potential negative effects. This is not unique for internet interventions, as limited data is available regarding...
Article
Background Internet- and mobile-based interventions (IMIs) targeting depression have been shown to be clinically effective and are considered a cost-effective complement to established interventions. The aim of this review was to provide an overview of the evidence for the cost-effectiveness of IMIs for the treatment and prevention of depression....
Article
Evidence for the impact of psychological Interventions for subthreshold depression (sD) is conflicting. Moreover, human resources to deliver such treatments are limited. This study aimed to evaluate the effectiveness of a web-based intervention with adherence-focused guidance in the treatment of sD. Participants with sD (CES-D ≥ 16, no Major Depres...
Article
Full-text available
Background Reducing the disease burden of major depressive disorder (MDD) is of major public health relevance. The prevention of depression is regarded as one possible approach to reach this goal. People with multiple risk factors for MDD such as chronic back pain and subthreshold depressive symptoms may benefit most from preventive measures. The I...
Article
Full-text available
Background: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. Objective: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD). Methods:...
Article
Study objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCB...
Article
In Reply We agree with Dr Anghelescu that it is remarkable that a major depressive episode can be prevented in people with subthreshold depression with a brief 6-session intervention. However, although this study was the first one showing that it is possible to prevent a major depressive episode using a web-based guided self-help intervention, evid...
Article
Aims: The aim of this systematic review of economic evaluations alongside randomised controlled trials (RCTs) was to provide a comprehensive overview of the evidence concerning cost-effectiveness analyses of common treatment options for major depression. Methods: An existing database was used to identify studies reporting cost-effectiveness resu...
Article
Importance Evidence-based treatments for major depressive disorder (MDD) are not very successful in improving functional and health outcomes. Attention has increasingly been focused on the prevention of MDD. Objective To evaluate the effectiveness of a web-based guided self-help intervention for the prevention of MDD. Design, Setting, and Partici...
Article
Full-text available
Background: Research on the effectiveness of treatments for subthreshold depression (sD) is still scarce. The aim of the study was to evaluate the efficacy of a web-based guided self-help intervention (GET.ON Mood Enhancer) in the treatment of sD. Methods: Participants with sD (n = 406) recruited from the general population via a large health in...
Chapter
Prevention of depression and its associated common mental disorders is a priority across the life cycle, and particularly in older adults. Currently available data from randomized clinical trials show that the rate of these disorders can be reduced on average 20'25 % over 1'2 years of follow-up. This is important with respect to: (1) reducing the c...
Article
Full-text available
Depressive disorders are highly prevalent, have a detrimental impact on the quality of life of patients and their relatives and are associated with increased mortality rates, high levels of service use and substantial economic costs. Current treatments are estimated to only reduce about one-third of the disease burden of depressive disorders. Preve...
Article
Full-text available
Major depressive disorder (MDD) imposes a considerable disease burden on individuals and societies. Web-based interventions have shown to be effective in reducing depressive symptom severity. However, it is not known whether web-based interventions may also be effective in preventing the onset of MDD. The aim of this study is to evaluate the (cost-...
Article
Major depressive disorder (MDD) imposes a considerable disease burden on individuals and societies. A large number of randomised controlled trials (RCTs) have shown the efficacy of Internet-based guided self-help interventions in reducing symptoms of depression. However, study quality varies considerably. The aim of this study is to evaluate the ef...

Projects

Projects (7)
Project
Chronic pain is a common problem in people working in green professions and impacts the ability to cope with everyday life and work. Specific interventions are indicated to reduce impairment of chronic pain and improve pain-related limitations. In this pragmatic two-armed randomized controlled trial PACT-A (n=286) a guided internet-based intervention is compared against enhanced treatment as usual (TAU+). The study is located at the Department of Clinical Psychology and Psychotherapy of the University of Ulm in cooperation with the Chair of Clinical Psychology and Psychotherapy of the Friedrich-Alexander-University Erlangen-Nuremberg. The target group are agriculturists, foresters and horticulturists (green professions) working as entrepreneurs, as well as collaborating spouses, family members and pensioners with chronic pain symptomology (at least Grade II according to the CPG) for a duration of least 6 months and adequate insurance status. The aim is to evaluate the effectiveness and cost-effectiveness of an internet-based intervention based on acceptance and commitment therapy (ACT) to reduce pain-related impairment. The intervention consisted of 7 modules over the course of 7 weeks and was guided by a trained eCoach. The intervention phase was followed by a 12-month consolidating phase with monthly contact to a trained eCoach. The control group had unrestricted access to standard care and additionally received information material on stress, depression and chronic pain as well as treatment offers in standard care. Assessments take place at baseline (T0), 9 weeks post-randomization (T1), and 6 (T2), 12 (T3), 24 (T4) and 36 months (T5) after randomization. The primary outcome is pain interference (Multidimensional Pain Interference scale; MPI) at T1. Secondary outcomes include depressive symptom severity (QIDS-SR16), psychological flexibility (CPAQ) and quality of life (AQoL-8D). The results of the study will provide valuable insights into short, medium and long-term (cost)effectiveness of an internet intervention for reduction of pain interference in chronic pain in the target group of green professions.
Project
Due to their living and working conditions, farmers are exposed to numerous psychological burdens (e.g. high workload, financial problems, bureaucracy). Depressive disorders often occur and are very stressful for those affected and their relatives. Specific preventive measures are indicated to reduce depressive burden and improve mental health in this occupational group. In this pragmatic two-armed randomized controlled trial PROD-A (n=360) a tailored and therapeutically guided preventive internet-based intervention (IMI) program is compared against enhanced treatment as usual (TAU+). The study is conducted at the Department of Clinical Psychology and Psychotherapy of the University of Ulm in cooperation with the Chair of Clinical Psychology and Psychotherapy of the Friedrich-Alexander-University Erlangen-Nuremberg. The target group are agriculturists, foresters and horticulturists (summarized as “green professions”) working as entrepreneurs, as well as collaborating spouses, family members and pensioners with at least subthreshold depression (PHQ-9 ≥ 5) and adequate insurance status. The aim is to evaluate the effectiveness and cost-effectiveness of a tailored IMI program for indicated prevention of depression consisting of six IMIs provided by an external service provider targeting depressive symptoms (GET.ON Mood Enhancer), depressive symptoms in diabetes (Mood Enhancer Diabetes), perceived stress (GET.ON Stress), insomnia (GET.ON Recovery), panic and agoraphobia (GET.ON Panic) and problematic alcohol consumption (GET.ON Be smart - Drink less). IMIs were assigned based on symptom screening and preference of participants. The intervention phase was followed by a 12-month consolidating phase with monthly contact to a trained eCoach. The control group had unrestricted access to standard care and additionally received information material on stress, depression and chronic pain as well as treatment offers in standard care. Assessments take place at baseline (T0), 9 weeks post-randomization (T1), and 6 (T2), 12 (T3), 24 (T4) and 36 months (T5) after randomization. The primary outcome was depressive symptom severity (QIDS-SR16) at T1. Secondary outcomes include incidence of depression (QIDS-SR16), quality of life (AQoL-8D) and negative effects (INEP). The results will provide valuable insights into short, medium and long-term (cost)effectiveness of an online-based program for depression prevention in the target group of green professions.
Project
The nationwide model project “Mit uns im Gleichgewicht” (With Us In Balance) aims to prevent depression among farmers, forest owners and horticulturists. The project is funded by the Social Insurance for Agriculture, Forestry and Horticulture (SVLFG) and is evaluated by the Friedrich-Alexander University Erlangen-Nürnberg and the University of Ulm. Farmers are a vulnerable population for developing depression or other mental health disorders due to a variety of risk factors in their work context (e.g. high workload, family conflicts, seasonal work). In order to maintain mental health of farmers, forester owners and horticulturists, the SVLFG offers on-site preventive measures such as workshops on stress management to the insured persons. Within the model project, these offers will be expanded to internet and tele-based interventions (guided internet interventions of the GET.ON Institute and personalized telebased coaching by IVPNetworks). It is evaluated in parallel running, randomised controlled trials whether the internet- and tele-based interventions are (cost-)effective in reducing depressive symptoms and other mental health concerns as well as in preventing the onset of clinical depression in this specific target group of farmers, gardeners and foresters. In addition, the implementation study aims to evaluate the implementation of tailored IMIs and a personalised telebased coaching in the routine care. If the clinical effectiveness of the internet- and tele-based services can be shown and the implementation succeeds, these services may be feasible in the long-term and health care in rural areas could be sustainably improved. The Department of Clinical Psychology and Psychotherapy of the FAU and the Department of Clinical Psychology and Psychotherapy University of Ulm, on behalf of SVLFG, are investigating in partly overlapping sub-projects the implementation and (cost-)effectiveness of the preventive interventions among farmers, forest owners and gardeners. Target group of the project: Insured individuals at the SVLFG, their co-insured partners and family members Project duration: 01.06.2017 – 30.05.2021