Examining an internet-delivered intervention for anxiety and depression when delivered as a part of routine care for university students: A phase IV trial.

There has been growing interest in the potential of emerging internet-delivered psychological treatments for supporting the mental health needs of university students. However, no large-scale prospective effectiveness trials examining their real-world potential have been reported. The aim of the current study was to evaluate the acceptability and effectiveness of a brief, 5-week, internet-delivered and therapist-guided intervention for anxiety and depression, when delivered as part of routine care by a university counselling service. A large, prospective, single-group Phase-IV clinical trial. Students (n = 1326) engaging with the university counselling service were provided the opportunity to receive the intervention based on their preferences and identified needs. Students completed standardised measures of anxiety and depression at pre-treatment, each week of the intervention, post-treatment and 3-month follow-up. Over a 4 year period, 1081 students (10% of those presenting to the counselling service) participated in the intervention. Large clinical reductions in symptoms of both anxiety (% reduction = 41%; Cohen's d = 0.94) and depression (% reduction = 36%; Cohen's d = 0.81) were observed alongside high levels of acceptability. The intervention required relatively little counsellor time (M = 36.28 mins; SD = 20.56) per student, and symptom deterioration was observed in less than 5% of students. The findings of the current study are supportive of internet-delivered interventions provided as routine care to university students. Further research is needed to carefully explore whether these interventions could be used with a larger proportion of students presenting to counselling services, paying close attention to acceptability, engagement and clinical outcomes.

Dear BF ，Johnson B ，Singh A ，Wilkes B ，Brkic T ，Gupta R ，Jones MP ，Bailey S ，Dudeney J ，Gandy M ，Fogliati R ，Titov N ... -  《-》

Exploring the efficacy and acceptability of Internet-delivered cognitive behavioural therapy for young adults with anxiety and depression: an open trial.

The highest prevalence of mental health problems is amongst people aged 18-24, with anxiety disorders and depression the most common disorders in this age group. Few young adults seek and receive effective care, prompting calls for the development of 'youth friendly' services. The Internet is a modality that has the potential to facilitate engagement with, and delivery of psychological treatments to, young adults. To date, however, no therapist-guided Internet-delivered treatments have been developed specifically for young adults experiencing depression and anxiety. To examine the efficacy and acceptability of a new therapist-guided Internet-delivered treatment for young adults aged 18-24 with symptoms of depression and anxiety. Participants accessed the Mood Mechanic Course, which consisted of four lessons delivered over 5 weeks. Measures of depression, anxiety, distress and disability were gathered before and after treatment, and at 3-month follow-up. Results were provided by 78% and 83% of participants at post-treatment and 3-month follow-up, respectively. Data were analysed using mixed linear model analyses. The trial was registered as: ACTRN12612001099819. Treatment significantly reduced depression and anxiety symptom severity, disability and distress at post-treatment and 3-month follow-up. Large within-group effect sizes were found at post-treatment and 3-month follow-up on all measures using both completer and estimated marginal means (Cohen's d = 1.02 to 1.41 and 0.94 to 1.45, respectively). The therapist spent an average of 37 minutes (SD = 18 minutes) in contact with participants during treatment. Participants rated the treatment as acceptable. Treatment gains recorded at post-treatment were sustained at 3-month follow-up, and were consistent with those reported in meta-analyses of Internet-delivered treatments developed for the broader adult population with depression and anxiety. These results provide encouraging preliminary evidence for the efficacy of therapist-guided Internet-delivered treatments for anxiety and depression tailored for young adults.

Johnston L ，Dear BF ，Gandy M ，Fogliati VJ ，Kayrouz R ，Sheehan J ，Rapee RM ，Titov N ... -  《-》

Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: a systematic review and meta-analysis.

Davies EB ，Morriss R ，Glazebrook C 《-》

Internet-delivered treatment for young adults with anxiety and depression: Evaluation in routine clinical care and comparison with research trial outcomes.

Mood and anxiety disorders typically emerge in adolescence and early adult life, but young adults are often reluctant to seek treatment. The Mood Mechanic course is a transdiagnostic internet-delivered psychological intervention for symptoms of depression and anxiety, targeted at people aged 18-24 years. The current study compared the efficacy of the course when delivered under strict research trial conditions (research trial; n = 192) with its effectiveness in a routine health-care setting (routine care; n = 222). Symptoms of depression, anxiety and general distress at baseline, during, and after treatment were measured by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Kessler 10-Item Scale (K-10), respectively. Both groups showed significant symptom reductions on all measures at post-treatment and 3-month follow-up. Deterioration rates were low, within-group effect sizes were large (>1.0) and both groups reported high levels of treatment satisfaction. Patients in routine care were less likely to complete post-treatment or follow-up symptom questionnaires. The study is based on self-reported data from treatment-seeking individuals that were motivated enough to start the course, and the absence of a control group and a formal diagnosis in the routine care sample means that some caution is needed in generalising the results. The results show that the Mood Mechanic course is effective and acceptable in routine clinical care, and that online psychological interventions designed for young adults are an effective treatment option for this hard-to-reach group.

Staples LG ，Dear BF ，Johnson B ，Fogliati V ，Gandy M ，Fogliati R ，Nielssen O ，Titov N ... -  《-》

Examining the effectiveness of a web-based intervention for symptoms of depression and anxiety in college students: study protocol of a randomised controlled trial.

The college years are a peak period for the onset of common mental disorders. Poor mental health is associated with low academic attainment, physical, interpersonal and cognitive impairments. Universities can use online approaches to screen students for mental disorders and treat those in need. The present study aims to assess the effectiveness of a guided web-based transdiagnostic individually tailored intervention to treat students with symptoms of depression and/or anxiety. and analysis : The present study is a randomised controlled trial. Participants are Dutch college students (≥18 years) with mild to moderate depression and/or anxiety symptoms. The intervention is a guided web-based transdiagnostic individually tailored intervention that targets symptoms of depression and/or anxiety. The intervention consists of seven online sessions with a duration ranging from 4 to 7 weeks depending on individual progress. A booster session is administered 4 weeks after the completion of the seventh session. Primary outcome measures are the Patient Health Questionnaire for depression and the Generalised Anxiety Disorder 7-item scale for anxiety. These scales are administered at screening, post-treatment and follow-up assessments (6 and 12 months post-randomisation). : E THICS AND DISSEMINATION: The Medical Ethics Committee of the Vrije Universiteit Medical Centre has approved the protocol (registration number 2016.583, A2017.362andA2018.421). Results of the trial will be published in a peer-reviewed journal. NTR6797; Pre-results.

Karyotaki E ，Klein AM ，Riper H ，Wit L ，Krijnen L ，Bol E ，Bolinski F ，Burger S ，Ebert DD ，Auerbach RP ，Kessler RC ，Bruffaerts R ，Batelaan N ，van der Heijde CM ，Vonk P ，Kleiboer A ，Wiers RW ，Cuijpers P ... -  《BMJ Open》