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

Paul Ritvo, Yuliya Knyahnytska, Meysam Pirbaglou, Wei Wang, George Tomlinson, Haoyu Zhao, Renee Linklater, Shari Bai, Megan Kirk, Joel Katz, Lillian Harber, Zafiris Daskalakis, Paul Ritvo, Yuliya Knyahnytska, Meysam Pirbaglou, Wei Wang, George Tomlinson, Haoyu Zhao, Renee Linklater, Shari Bai, Megan Kirk, Joel Katz, Lillian Harber, Zafiris Daskalakis

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.

Keywords: CBT; clinical trial; cognitive behavioral therapy; depression; electronic CBT; intervention study; online intervention; online therapy; telemedicine; young adult; youth.

Conflict of interest statement

Conflicts of Interest: ZD received research support and in-kind equipment support for an investigator-initiated study from Brainsway, Ltd. He is the site principal investigator for sponsor-initiated studies for Brainsway, Ltd. He also receives in-kind equipment support Magventure for investigator-initiated research. The other authors have no conflicts of interest to declare.

©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.

Figures

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Figure 1
Consort flow diagram.

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