Effect of email-delivered CBT-I on insomnia, anxiety, and depression for university students in Japan: a randomized controlled trial

BACKGROUND Depression and anxiety symptoms are common among university students, but many do not receive treatment. This is often because of lack of availability, reluctance to seek help, and not meeting the diagnostic criteria required to access services. Internet-based interventions, including smartphone apps, can overcome these issues. However, a large number of apps are available, each with little evidence of their effectiveness. OBJECTIVE This study aims to evaluate for the first time the effectiveness of a self-guided mobile app, Feel Stress Free, for the treatment of depression and anxiety symptoms in students. METHODS A web-based randomized controlled trial compared a cognitive behavioral therapy (CBT)–based mobile app Feel Stress Free with a wait-list control. University students self-identified as experiencing symptoms of anxiety or depression and were randomized to 6 weeks of intervention (n=84) or control (n=84), unblinded. The app is self-guided and incorporates behavioral relaxation activities, mood tracking and thought challenging, and minigames. Participants completed the Hospital Anxiety and Depression Scale online at baseline and every fortnight. RESULTS At week 6, the primary end point, there was evidence that the Feel Stress Free app reduced depression symptoms (mean difference −1.56; 95% CI −2.67 to −0.44; P=.006) but only very weak evidence that it reduced anxiety symptoms (mean difference −1.36; 95% CI −2.93 to 0.21; P=.09). At week 4, there was evidence to support the effectiveness of the intervention for anxiety symptoms (mean difference −1.94; 95% CI −3.11 to −0.77; P=.001) and, though weaker, depression symptoms (mean difference −1.08; 95% CI −2.12 to −0.04; P=.04). At week 6, 83% (34/41) of participants indicated that they were using the app weekly or more frequently. CONCLUSIONS The Feel Stress Free app is a promising mobile intervention for treating symptoms of anxiety and depression in students and overcomes many of the barriers to traditional CBT. Further research is needed to establish its effectiveness at and beyond 6 weeks. CLINICALTRIAL ClinicalTrials.gov NCT03032952; https://clinicaltrials.gov/ct2/show/NCT03032952

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Effects of an eight-week, online mindfulness program on anxiety and depression in university students during COVID-19: A randomized controlled trial

Psychiatry Research ◽

10.1016/j.psychres.2021.114222 ◽

2021 ◽

Vol 305 ◽

pp. 114222

Author(s):

Otto Simonsson ◽

Olivier Bazin ◽

Stephen D. Fisher ◽

Simon B. Goldberg

Keyword(s):

Randomized Controlled Trial ◽

University Students ◽

Controlled Trial ◽

Anxiety And Depression ◽

Randomized Controlled

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Effectiveness of a Mobile App Intervention for Anxiety and Depression Symptoms in University Students: Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/15418 ◽

2020 ◽

Vol 8 (7) ◽

pp. e15418

Author(s):

Tayla McCloud ◽

Rebecca Jones ◽

Gemma Lewis ◽

Vaughan Bell ◽

Elias Tsakanikos

Keyword(s):

Randomized Controlled Trial ◽

University Students ◽

Controlled Trial ◽

Mobile App ◽

Anxiety Symptoms ◽

Mean Difference ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Depression And Anxiety ◽

Randomized Controlled

Background Depression and anxiety symptoms are common among university students, but many do not receive treatment. This is often because of lack of availability, reluctance to seek help, and not meeting the diagnostic criteria required to access services. Internet-based interventions, including smartphone apps, can overcome these issues. However, a large number of apps are available, each with little evidence of their effectiveness. Objective This study aims to evaluate for the first time the effectiveness of a self-guided mobile app, Feel Stress Free, for the treatment of depression and anxiety symptoms in students. Methods A web-based randomized controlled trial compared a cognitive behavioral therapy (CBT)–based mobile app Feel Stress Free with a wait-list control. University students self-identified as experiencing symptoms of anxiety or depression and were randomized to 6 weeks of intervention (n=84) or control (n=84), unblinded. The app is self-guided and incorporates behavioral relaxation activities, mood tracking and thought challenging, and minigames. Participants completed the Hospital Anxiety and Depression Scale online at baseline and every fortnight. Results At week 6, the primary end point, there was evidence that the Feel Stress Free app reduced depression symptoms (mean difference −1.56; 95% CI −2.67 to −0.44; P=.006) but only very weak evidence that it reduced anxiety symptoms (mean difference −1.36; 95% CI −2.93 to 0.21; P=.09). At week 4, there was evidence to support the effectiveness of the intervention for anxiety symptoms (mean difference −1.94; 95% CI −3.11 to −0.77; P=.001) and, though weaker, depression symptoms (mean difference −1.08; 95% CI −2.12 to −0.04; P=.04). At week 6, 83% (34/41) of participants indicated that they were using the app weekly or more frequently. Conclusions The Feel Stress Free app is a promising mobile intervention for treating symptoms of anxiety and depression in students and overcomes many of the barriers to traditional CBT. Further research is needed to establish its effectiveness at and beyond 6 weeks. Trial Registration ClinicalTrials.gov NCT03032952; https://clinicaltrials.gov/ct2/show/NCT03032952

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