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Email-based promotion of self-help for subthreshold depression: Mood Memos randomised controlled trial

  • Amy J. Morgan (a1), Anthony F. Jorm (a1) and Andrew J. Mackinnon (a1)

Subthreshold depression is common, impairs functioning and increases the risk of major depression. Improving self-help coping strategies could help subthreshold depression and prevent major depression.


To test the effectiveness of an automated email-based campaign promoting self-help behaviours.


A randomised controlled trial was conducted through the website: Participants received automated emails twice weekly for 6 weeks containing advice about self-help strategies. Emails containing general information about depression served as a control. The principal outcome was depression symptom level on the nine-item Patient Health Questionnaire (PHQ-9) (trial registration: ACTRN12609000925246).


The study recruited 1326 adults with subthreshold depression. There was a small significant difference in depression symptoms at post-intervention, favouring the active group (d = 0.17, 95% CI 0.01–0.34). There was a lower, although non-significant, risk of major depression in the active group (number needed to treat (NNT) 25, 95% CI 11 to ∞ to NNT(harm) 57).


Emails promoting self-help strategies were beneficial. Internet delivery of self-help messages affords a low-cost, easily disseminated and highly automated approach for indicated prevention of depression.

Corresponding author
Amy J. Morgan, Orygen Youth Health Research Centre, University of Melbourne, Locked Bag 10, Parkville, Victoria 3052, Australia. Email:
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Funded by a National Health and Medical Research Council Postgraduate Scholarship (567056) and a Sidney Myer Health Scholarship. Orygen Youth Health Research Centre receives funding from the Colonial Foundation.

Declaration of interest

A. J. Morgan is the author and developer of the Mood Memos website but derives no personal or financial benefit from its operation.

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Email-based promotion of self-help for subthreshold depression: Mood Memos randomised controlled trial

  • Amy J. Morgan (a1), Anthony F. Jorm (a1) and Andrew J. Mackinnon (a1)
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