Unobserved Heterogeneity in Response to Treatment for Depression Through Videoconference
Objective: This study examined treatment response heterogeneity in a recent randomized controlled trial of treatment for depression using videoconferencing technology compared to traditional in-office care. Method: Growth mixture modeling was used to identify subgroups of individuals in the trial based on treatment response trajectories. Demographic and baseline characteristics were included to identify correlates of subgroup membership. Results: There were two subgroups based on the trajectories of the Beck Hopelessness Scale. The first subgroup had less symptom severity at baseline, and there was no meaningful difference between the two treatment modalities in change over time. The second subgroup had higher symptom severity at baseline, and individuals who engaged in treatment through the videoconference modality had less symptom improvement than those who underwent the in-office modality. Older participants with higher loneliness and anxiety scores at baseline were more likely to be in the second group. Conclusions and Implications for Practice: Treatment of depression using videoconferencing to deliver care to an individual’s home offers opportunities for improved access to services, especially among those who are unwilling or unable to seek in-person treatment. However, videoconferencing may not be appropriate for everyone. An individual’s symptom level, age, and comorbidities are important clinical considerations when selecting an appropriate treatment modality.