Trial reportEvidence-based mental health2022
Components of smartphone cognitive-behavioural therapy for subthreshold depression among 1093 university students: a factorial trial.
Trial report in Evidence-based mental health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Heterogeneity of Treatment Effects in Internet- and Mobile-Based Interventions for Depression: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Skill Enactment and Knowledge Acquisition in Digital Cognitive Behavioral Therapy for Depression and Anxiety: Systematic Review of Randomized Controlled Trials.Journal of medical Internet research · 2023Pooled it
- Smartphone cognitive behavioral therapy for prevention of depressive symptoms in patients with recurrent pregnancy loss: an exploratory decentralized, parallel-group, multicenter, open, individually randomized, fully factorial trial.Psychiatry and clinical neurosciences · 2026Trial
- Trial
- Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial.JMIR formative research · 2025Trial
- Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: the RESiLIENT randomized controlled trial.Nature medicine · 2025Trial
- Long-Term Effects of Internet-Based Cognitive Behavioral Therapy on Depression Prevention Among University Students: Randomized Controlled Factorial Trial.JMIR mental health · 2024Trial
- Optimizing smartphone psychotherapy for depressive symptoms in patients with cancer: Multiphase optimization strategy using a decentralized multicenter randomized clinical trial (J-SUPPORT 2001 Study).Psychiatry and clinical neurosciences · 2024Trial
- A chatbot to improve adherence to internet-based cognitive-behavioural therapy among workers with subthreshold depression: a randomised controlled trial.BMJ mental health · 2024Trial
- Big data and psychiatry: advances, constraints and future directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Identifying the active ingredients of a behavioral activation-based digital single-session intervention targeting depression.Clinical psychological science : a journal of the Association for Psychological Science · 2026Article
- Article
- Innovations to improve outcomes and uptake of psychotherapies for mental disorders: a state-of-the-art review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Article
- Improvements in depression symptomatology in a sample of undergraduate students: a pre-post Balint group intervention study.BMC psychology · 2025Article
- The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2025Article
- Short-term alterations of brain network properties in subthreshold depression: the impact of Internet-based Cognitive Behavioral Therapy.Frontiers in neurology · 2025Article
- Systematic review and meta-analysis of adverse events in clinical trials of mental health apps.NPJ digital medicine · 2024Article
- Dynamics of depressive states among university students in Japan during the COVID-19 pandemic: an interrupted time series analysis.Annals of general psychiatry · 2023Article
- Identifying active ingredients in cognitive-behavioral therapies: What if we didn't?Behaviour research and therapy · 2023Article
Corrections and comments
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Authors and funding
27 authors at 12 institutions in 3 countries.
Funding
Abstract
backgroundInternet-based cognitive-behavioural therapy (iCBT) is effective for subthreshold depression. However, which skills provided in iCBT packages are more effective than others is unclear. Such knowledge can inform construction of more effective and efficient iCBT programmes.
objectiveTo examine the efficacy of five components of iCBT for subthreshold depression.
methodsWe conducted an factorial trial using a smartphone app, randomly allocating presence or absence of five iCBT skills including self-monitoring, behavioural activation (BA), cognitive restructuring (CR), assertiveness training (AT) and problem-solving. Participants were university students with subthreshold depression. The primary outcome was the change on the Patient Health Questionnaire-9 (PHQ-9) from baseline to week 8. Secondary outcomes included changes in CBT skills.
findingsWe randomised a total of 1093 participants. In all groups, participants had a significant PHQ-9 reduction from baseline to week 8. Depression reduction was not significantly different between presence or absence of any component, with corresponding standardised mean differences (negative values indicate specific efficacy in favour of the component) ranging between -0.04 (95% CI -0.16 to 0.08) for BA and 0.06 (95% CI -0.06 to 0.18) for AT. Specific CBT skill improvements were noted for CR and AT but not for the others.
conclusionsThere was significant reduction in depression for all participants regardless of the presence and absence of the examined iCBT components. CLINICAL IMPLICATION: We cannot yet make evidence-based recommendations for specific iCBT components. We suggest that future iCBT optimisation research should scrutinise the amount and structure of components to examine. TRIAL REGISTRATION NUMBER: UMINCTR-000031307.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.