Evidence map›Paper›PMID 41013730›Full record

ArticleTrials2025

A randomized controlled trial of Internet-delivered guided and unguided cognitive behaviour therapy for treating depression and anxiety in UK university students: study protocol for the Nurture-U Internet CBT trial.

E R Watkins, D Phillips, H Choueiri, A Ford, H Cook, G Taylor, R C Kessler

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

E R WatkinsMood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK. e.r.watkins@exeter.ac.uk.ORCID http://orcid.org/0000-0002-2432-5577
D PhillipsClinical Trials Unit, Medical School, University of Exeter, University of Exeter, Exeter, UK.
H ChoueiriMood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK.
A FordMood Disorders Centre, School of Psychology, Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Exeter, EX4 4LN, UK.
H CookClinical Trials Unit, Medical School, University of Exeter, University of Exeter, Exeter, UK.
G TaylorClinical Trials Unit, Medical School, University of Exeter, University of Exeter, Exeter, UK.
R C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.

Funding

Medical Research Council MR/W002442/1
6 · The paper itself

Abstract

backgroundTackling poor mental health in university students is a priority in higher education. Although major depressive disorder and generalized anxiety disorder are highly prevalent among university students and predict impaired university and later life outcomes, most students do not receive evidence-based treatment. Internet-delivered cognitive-behavioural therapy (iCBT) is increasingly offered to UK university students in guided or unguided formats. Our aim is to compare the effects of guided versus unguided scalable iCBT for university students with elevated symptoms of depression and/or anxiety and to investigate the feasibility of creating individual treatment rules (ITR) to predict for whom which variant of iCBT is more effective as well as for whom neither is effective.

methodsAn online single-blind, two-arm parallel-group randomized controlled trial to examine symptoms of depression and anxiety across 3 months in university students aged over 16 who screen into the study with self-reported high levels of anxiety (GAD-7 > 9) and/or depression (PHQ-9 > 9). Eligible participants will be randomized to guided transdiagnostic iCBT supported by a psychological wellbeing practitioner or to the same transdiagnostic iCBT content as unguided self-help. In total, 720 participants with no current bipolar disorder or psychosis will be recruited from UK universities. Assessments will take place at baseline (pre-randomization) and 3 months post-randomization. Primary endpoints and outcomes are self-reported depression and anxiety symptoms at 3-month follow-up, adjusting for baseline scores. Well-being, health-related quality of life, functioning and academic outcomes are secondary outcomes. Compliance, adverse events, and potentially mediating variables will be monitored. We will use machine learning to estimate heterogeneity of treatment effects and develop an ITR to optimize the allocation of students to either unguided or guided iCBT. DISCUSSION: The trial aims to provide a better understanding of the relative benefits of guided and unguided iCBT for anxiety and depression in university students with considerable implications for treatment coverage and service planning and delivery. We will provide innovative information to optimize treatment assignment, guide university mental health treatment planning and support evidence-based and scalable interventions for the most common mental health problems in university students.

trial registrationISRCTN: 56784470, https://www.isrctn.com/ISRCTN56784470 . Registered on 27 October 2022.

Indexed as

AnxietyCognitive Behavioral TherapyDepressionInternet-Based InterventionStudentsTherapy, Computer-AssistedAdolescentFemaleHumansInternetMaleRandomized Controlled Trials as TopicSingle-Blind MethodTime FactorsTreatment OutcomeUnited KingdomAnxietyDepressionICBTPrecision treatment algorithmRandomized controlled trialUniversity students

Identifiers

PMID41013730
PMCPMC12465736

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Registered trials

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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.