Digital Interventions for Relapse Prevention in Adolescence (DigiTIFF)

Some adolescents experience periods of anxiety and/or depression, and some find that these periods return over time. The purpose of this study is to examine whether digital interventions-where individuals work systematically with their own thoughts and feelings during periods when they feel well-can help them maintain well-being for longer.

The study includes adolescents aged 16-19 who have previously experienced episodes of depression and/or anxiety to a degree that led them to seek help (e.g., from a school nurse, general practitioner, health clinic, or child and adolescent mental health service). Through a research app on their smartphones, participants complete tasks and answer questionnaires. The study is fully digital. Some participants meet with a therapist in digital group sessions, while others work independently with the digital content.

We will also examine the cost-benefit aspects of offering such interventions. If the study achieves its goals, digital interventions may eventually become a service offered to adolescents recovering from depression and anxiety.

Study Overview

• Status: Not yet recruiting
• Conditions: Major Depression Disorder; ANXIETY DISORDERS (or Anxiety and Phobic Neuroses)
• Intervention / Treatment: Behavioral: Transdiagnostic app intervention; Behavioral: Transdiagnostic mastery course

• Study Type: Interventional
• Enrollment (Estimated): 495
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ragnhild Bø, Ph.D.; Phone Number: +47 41904595; Email: ragnhild.bo@psykologi.uio.no

Study Locations

• Norway
  • Oslo, Norway
    • University of Oslo
    • Contact: Ragnhild Bø, PhD; Phone Number: +47 41904595; Email: ragnhild.bo@psykologi.uio.no

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Currently in full or partial remission for a minimum of 2 months from a depressive disorder or an anxiety disorder as defined by self-reported scores on RCADS-47: previous episode(s) of t-score > 65 and current t-score =<65.
• Native or fluent Scandinavian language skills.
• Willingness to take part even when allocated to the non-preferred arm of the trial.

Exclusion Criteria:

• Ongoing depressive disorder, ongoing anxiety disorder as defined by current t-score =<65 on RCADS-47.
• Recent completion of one of the interventions in the two interventional arms.
• no available smartphone.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: App intervention; A transdiagnostic, self-guided CBT app: Standardized self-assessment for mental health: 'Test your psychological immune system'.; Educational mini-series: A 30-minute, entertaining video series that teaches users to build resilience by addressing essential needs like sleep (psychological immune system), recognizing negative thought patterns (thought viruses), and developing healthier coping mechanisms (psychological vitamins).; Daily practice: Over 20 days, users receive a short, 1-2-minute video each morning. These videos provide practical tips, small experiments, or simple tasks designed to help users integrate healthier coping strategies into their daily lives.	Behavioral: Transdiagnostic app intervention; A transdiagnostic, self-guided CBT app, called TankeVirus (literally translated Thought Viruses), consisting of three components: Standardized self-assessment for mental health: 'Test your psychological immune system'.; Educational mini-series: A 30-minute, entertaining video series that teaches users to build resilience by addressing essential needs like sleep (psychological immune system), recognizing negative thought patterns (thought viruses), and developing healthier coping mechanisms (psychological vitamins).; Daily practice: Over 20 days, users receive a short, 1-2-minute video each morning. These videos provide practical tips, small experiments, or simple tasks designed to help users integrate healthier coping strategies into their daily lives.
Experimental: Group intervention; A transdiagnostic, mastery course for groups, delivered weekly in webinar format over three sessions. It includes videos and group discussions.	Behavioral: Transdiagnostic mastery course; Group-based webinar offering psychoeducation based on principles of CBT.
No Intervention: Assessment only; Only assessment will be conducted.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Relapse: Number of participants scoring above the diagnostic cut-off on the PHQ-9 modified for teens during the 12-month follow-up.	To use the PHQ-9 as a diagnostic aid for Major Depressive Disorder: Questions 1 and/or 2 need to be endorsed as a "2" or "3"; Need five or more positive symptoms (positive is defined by a "2" or "3" in questions 1-8 and "1", "2", or "3" in question 9).; The functional impairment question (How difficult….) needs to be rated at least as "somewhat difficult."	From enrollment to the end of follow-up at 12-months.
Time until relapse; reaching the diagnostic criteria of MDD according to PHQ-9 modified for teens	Number of days until the diagnostic criteria of MDD as assessed PHQ-9 modified for teens has been reached. - Questions 1 and/or 2 need to be endorsed as a "2" or "3"; Need five or more positive symptoms (positive is defined by a "2" or "3" in questions 1-8 and by a "1", "2", or "3" in question 9).; The functional impairment question (How difficult….) needs to be rated at least as "somewhat difficult."	From enrollment to 12-months follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Repetitive negative thinking (RNT-10)	Assess transdiagnostic repetitive negative thinking	At enrollment, and at 3, 6 and 12 months follow-up
Somatic complaints (SSS8)	Somatic complaints based on sum score of all items	At enrollment, and at 3, 6, and 12-months follow-up.
EPOCH Measure of Adolescent Well-Being	A 20-item validated questionnaire (4 items per domain; Engagement, Perseverance, Optimism, Connectedness, Happiness) on a 1-5 Likert scale (1=Almost Never, 5=Almost Always) resulting in domain scores, reflecting strengths in these positive psychological areas crucial for youth well-being.	At baseline, 3, 6 and 12-months follow-up.
Health related quality of life	EQ-5D-5L will be used to assess five domains of patient reported outcomes and for economic evaluation of the interventions.	At baseline, 3, 6 and 12-months follow-up.
Health related quality of life - Visual Analog Scale	EQ VAS will be used to assess patient reported outcomes for self-rated health and for economic evaluation of the interventions.	At baseline, 3, 6 and 12-months follow-up.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Client satisfaction questionnaires (CSQ-I)	The 8-item questionnaire assesses how satisfied the participants are with the interventions, only administrated to those who are in the interventional arms.	At 3 months follow-up.

Collaborators and Investigators

• Sponsor: University of Oslo

Publications and helpful links

Helpful Links

• Project webpage

Study record dates

Study Major Dates

• Study Start (Estimated): April 7, 2026
• Primary Completion (Estimated): June 1, 2027
• Study Completion (Estimated): June 1, 2027

Study Registration Dates

• First Submitted: December 22, 2025
• First Submitted That Met QC Criteria: January 7, 2026
• First Posted (Actual): January 16, 2026

Study Record Updates

• Last Update Posted (Actual): March 13, 2026
• Last Update Submitted That Met QC Criteria: March 12, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Transdiagnostic interventions
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders; Phobic Disorders
• Other Study ID Numbers: 870757

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The dataset underlying the results will be shared together with publications.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No