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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Anna Carlotta Zarski - , University of Marburg, Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Kiona K. Weisel - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Thomas Berger - , University of Bern (Author)
  • Tobias Krieger - , University of Bern (Author)
  • Michael P. Schaub - , University of Zurich (Author)
  • Matthias Berking - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Dennis Görlich - , University of Münster (Author)
  • Corinna Jacobi - , Chair of Clinical Psychology and E-Mental-Health, TUD Dresden University of Technology (Author)
  • David D. Ebert - , Technical University of Munich (Author)

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 languageEnglish
Pages (from-to)155-168
Number of pages14
JournalPsychotherapy and psychosomatics
Volume93
Issue number3
Publication statusPublished - 30 Apr 2024
Peer-reviewedYes

External IDs

PubMed 38688243

Keywords

Sustainable Development Goals

Keywords

  • Internet intervention, Subclinical anxiety, Subclinical depression, Subthreshold disorders, Transdiagnostic prevention