Efficacy of an Internet- and Mobile-Based Intervention for Subclinical Anxiety and Depression (ICare Prevent) with Two Guidance Formats: Results from a Three-Armed Randomized Controlled Trial
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Contributors
Abstract
Introduction: Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. Objective: This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). Methods: Participants included 566 adults with subclinical anxiety (GAD-7 5) and/or depressive (CES-D 16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7- session IMI plus booster session with IG-IMI (n = 186) or AGIMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. Results: Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. Conclusions: A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12- month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives. ? 2024 The Author(s). Published by S. Karger AG, Basel.
Details
Original language | English |
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Pages (from-to) | 155-168 |
Number of pages | 14 |
Journal | Psychotherapy and psychosomatics |
Volume | 93 |
Issue number | 3 |
Publication status | Published - 30 Apr 2024 |
Peer-reviewed | Yes |
External IDs
PubMed | 38688243 |
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Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Internet intervention, Subclinical anxiety, Subclinical depression, Subthreshold disorders, Transdiagnostic prevention