Long-Term Effects of Internet-Based Cognitive Behavioral Therapy on Depression Prevention Among University Students: Randomized Controlled Factorial Trial.

Background: Internet-based cognitive behavioral therapy (iCBT) shows promise in the prevention of depression. However, the specific iCBT components that contribute to its effectiveness remain unclear. Objective: We aim to evaluate the effects of iCBT components in preventing depression among univers...

Full description

Bibliographic Details
Published in:JMIR Mental Health Vol. 11; pp. 1 - 15
Main Authors: Nakagami, Yukako, Uwatoko, Teruhisa, Shimamoto, Tomonari, Sakata, Masatsugu, Toyomoto, Rie, Yoshida, Kazufumi, Luo, Yan, Shiraishi, Nao, Tajika, Aran, Sahker, Ethan, Horikoshi, Masaru, Noma, Hisashi, Iwami, Taku, Furukawa, Toshi A
Format: research tables/charts randomized controlled trial Journal Article
Published: JMIR Publications Inc. 2024
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180451872&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 180451872
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        23687959
        MUYH
      jtl: JMIR Mental Health
      issn: 23687959
      maglogo: N
    pubinfo:
      dt: 2024
      vid: 11
      pid: 21567
      pub: JMIR Publications Inc.
      place: Toronto, Ontario
    artinfo:
      ui:
        180451872
        180451872
        180451872
        10.2196/56691
        180451872
      ppf: 1
      ppct: 14
      formats:
      tig:
        atl: Long-Term Effects of Internet-Based Cognitive Behavioral Therapy on Depression Prevention Among University Students: Randomized Controlled Factorial Trial.
      aug:
        au:
          Nakagami, Yukako
          Uwatoko, Teruhisa
          Shimamoto, Tomonari
          Sakata, Masatsugu
          Toyomoto, Rie
          Yoshida, Kazufumi
          Luo, Yan
          Shiraishi, Nao
          Tajika, Aran
          Sahker, Ethan
          Horikoshi, Masaru
          Noma, Hisashi
          Iwami, Taku
          Furukawa, Toshi A
        affil: Kyoto University Health Service, Kyoto University, Kyoto, Japan
      sug:
        subj:
          Cognitive Therapy Methods
          Internet-Based Intervention Methods
          Depression Therapy
          Student Attitudes
          Students, College Psychosocial Factors
          Human
          Male
          Female
          Adult
          Middle Age
          Japan
          Randomized Controlled Trials
          Random Assignment
          Treatment Outcomes
          Interview Guides
          Questionnaires
          Depression Prevention and Control
          Anxiety Prevention and Control
          Data Analysis Software
          Regression
          Kaplan-Meier Estimator
          Multimethod Studies
          Independent Variable
          Descriptive Statistics
          Confidence Intervals
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background: Internet-based cognitive behavioral therapy (iCBT) shows promise in the prevention of depression. However, the specific iCBT components that contribute to its effectiveness remain unclear. Objective: We aim to evaluate the effects of iCBT components in preventing depression among university students. Methods: Using a smartphone cognitive behavioral therapy (CBT) app, we randomly allocated university students to the presence or absence of 5 different iCBT components: self-monitoring, behavioral activation, cognitive restructuring, assertiveness training, and problem-solving. The active intervention lasted 8 weeks but the app remained accessible through the follow-up. The primary outcome was the onset of a major depressive episode (MDE) between baseline and the follow-up after 52 weeks, as assessed with the computerized World Health Organization Composite International Diagnostic Interview. Secondary outcomes included changes in the 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder, and CBT Skills Scale. Results: During the 12-month follow-up, 133 of 1301 (10.22%) participants reported the onset of an MDE. There were no significant differences in the incidence of MDEs between the groups with or without each component (hazard ratios ranged from 0.85, 95% CI 0.60-1.20, for assertiveness training to 1.26, 95% CI 0.88-1.79, for self-monitoring). Furthermore, there were no significant differences in the changes on the 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder, or for CBT Skills Scale between component allocation groups. However, significant reductions in depression and anxiety symptoms were observed among all participants at the 52-week follow-up. Conclusions: In this study, we could not identify any specific iCBT components that were effective in preventing depression or the acquisition of CBT skills over the 12-month follow-up period, but all participants with and without intervention of each iCBT component demonstrated significant improvements in depressive and anxiety symptoms. Further research is needed to explore the potential impact of frequency of psychological assessments, nonspecific intervention effects, natural change in the mental state, and the baseline depression level.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N