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The aim is to describe feedback from the adolescents on their use of a web-based depression support system. Web-based support systems can serve as an alternative to conventional treatment or to complement the current services. Mixed methods were used to approach the topic from multiple perspectives. Feedback was collected from adolescents with symptoms of depression or anxiety. Adolescents (n = 46) responded to a questionnaire after participating on the support system, and 24 adolescents did not provide feedback. The data were analyzed with quantitative descriptive statistics and qualitative thematic analysis. Out of 45 adolescents, 93% agreed that the web-based support system was targeted at them, and 89% felt it was reliable and safe. It was perceived as a good channel for reflecting thoughts. However, some adolescents felt it was difficult to use or that using it did not help them. Ideas for development were also offered. Depis.Net provided the adolescents with a reliable way to ease their condition at home. Using feedback from the adolescents on the support system makes it possible to identify those who are able to use this kind of system in daily practice.

Katriina I Anttila,1,2 Minna J Anttila,1 Marjo H Kurki,1 Maritta A Välimäki1,3,4 1Department of Nursing Science, University of Turku, Turku, 2Helsinki University Hospital, Children and Adolescents, Child Psychiatry, Helsinki, 3Turku University Hospital, Development Unit, Turku, Finland; 4School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong, People’s Republic of China Abstract: Social relationships among adolescents with mental disorders are demanding. Adolescents with depressive symptoms may have few relationships and have difficulties sharing their problems. Internet may offer reliable and easy to use tool to collect real-time information from adolescents. The aim of this study is to explore how adolescents describe their social relationships with an electronic diary. Mixed methods were used to obtain a broad picture of adolescents’ social relationships with the data gathered from network maps and reflective texts written in an electronic diary. Adolescents who visited an outpatient clinic and used an intervention (N=70) designed for adolescents with signs of depression were invited to use the electronic diary; 29 did so. The quantitative data gathered in the electronic diary were summarized with descriptive statistics, and the qualitative data were categorized using a thematic analysis with an inductive approach. We found that social relationships among adolescents with signs of depression can vary greatly in regards to the number of existing relationships (from lacking to 21) and the quality of the relationships (from trustful to difficult). However, the relationships may change, and the adolescents are also willing to build up their social relationships. Professionals need to be aware of the diversity of adolescents’ social relationships and their need for personalized support. Keywords: adolescent, depression, electronic diary, internet, social relationship

BackgroundAlthough previous studies on information and communication technology (ICT)–based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants’ engagement of these interventions, and how these interventions work. ObjectiveWe conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes. MethodsWe included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology. ResultsOut of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; P