Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth With Major Depressive Disorders: Randomized Controlled Trial

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Abstract

Background

Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders.

Objective

We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder.

Methods

Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging.

Results

In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference –8.54, P=.01), Quick Inventory of Depressive Symptoms score (difference –4.94, P=.001), Beck Anxiety Inventory score (difference –11.29, P<.001), and Brief Pain Inventory score (difference –1.99, P=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire–Nonjudging subscale (difference –2.68, P=.05).

Conclusions

These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction.

Trial Registration

Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052

Related collections

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Author and article information

Contributors

Zafiris Daskalakis:

ORCID: https://orcid.org/0000-0001-9502-0538

Department of PsychiatryUniversity of California San Diego9500 Gilman DriveLa Jolla, CA, 92093United States1 (858) 534 2230zdaskalakis@health.ucsd.edu

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J Med Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: March 2021

Publication date (Electronic): 10 March 2021

Volume: 23

Issue: 3

Electronic Location Identifier: e24380

Affiliations

[1 ] School of Kinesiology and Health Sciences York University Toronto, ON Canada

[2 ] Department of Psychology York University Toronto, ON Canada

[3 ] Department of Psychiatry University of Toronto Toronto, ON Canada

[4 ] Centre for Addiction and Mental Health Toronto, ON Canada

[5 ] Temerty Centre for Therapeutic Brain Intervention Centre for Addiction and Mental Health Toronto, ON Canada

[6 ] THETA Collaborative University Health Network University of Toronto Toronto, ON Canada

[7 ] Biostatistics Unit University Health Network University of Toronto Toronto, ON Canada

[8 ] Aboriginal Engagement and Outreach Centre for Addiction and Mental Health Toronto, ON Canada

[9 ] Department of Psychology University of Toronto Toronto, ON Canada

[10 ] Department of Psychiatry University of California San Diego La Jolla, CA United States

[11 ] Mood and Anxiety Ambulatory Services Centre for Addiction and Mental Health Toronto, ON Canada

Author notes

Corresponding Author: Zafiris Daskalakis zdaskalakis@ 123456health.ucsd.edu

Author information

Paul Ritvo https://orcid.org/0000-0003-1141-0083

Yuliya Knyahnytska https://orcid.org/0000-0002-1882-4505

Meysam Pirbaglou https://orcid.org/0000-0001-5951-9577

Wei Wang https://orcid.org/0000-0002-0336-506X

George Tomlinson https://orcid.org/0000-0002-9328-6399

Haoyu Zhao https://orcid.org/0000-0002-0541-8495

Renee Linklater https://orcid.org/0000-0003-2881-4914

Shari Bai https://orcid.org/0000-0002-5589-3470

Megan Kirk https://orcid.org/0000-0002-2069-2177

Joel Katz https://orcid.org/0000-0002-8686-447X

Lillian Harber https://orcid.org/0000-0003-2134-7911

Zafiris Daskalakis https://orcid.org/0000-0001-9502-0538

Article

Publisher ID: v23i3e24380

DOI: 10.2196/24380

PMC ID: 7991990

PubMed ID: 33688840

SO-VID: 7408b285-7534-4072-b919-dac21c7fd85a

Copyright © ©Paul Ritvo, Yuliya Knyahnytska, Meysam Pirbaglou, Wei Wang, George Tomlinson, Haoyu Zhao, Renee Linklater, Shari Bai, Megan Kirk, Joel Katz, Lillian Harber, Zafiris Daskalakis. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.03.2021.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 21 September 2020

Date revision requested : 9 October 2020

Date revision received : 30 November 2020

Date accepted : 10 January 2021

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