iCBT (secondary analysis, guided iCBT vs. self-guided iCBT)
Trial question
Is clinician-guided iCBT superior to self-guided iCBT among university students with anxiety and depression?
Study design
Multi-center
Open label
RCT
Population
884 patients.
Inclusion criteria: university students with anxiety and/or depression.
Key exclusion criteria: positive screens for lifetime bipolar disorder or nonaffective psychosis or recent suicidal ideation with intent.
Interventions
N=445 clinician-guided iCBT (guides sent online weekly messages to users designed to create personalized experiences and provide feedback).
N=439 self-guided iCBT (no personalized messages received from clinicians).
Primary outcome
Joint remission of anxiety and depression at 3 months
51.8%
37.8%
51.8 %
38.8 %
25.9 %
12.9 %
0.0 %
Clinician-guided internet-delivered cognitive behavioral
therapy
Self-guided internet-delivered cognitive behavioral
therapy
Significant
increase ▲
NNT = 7
Significant increase in joint remission of anxiety and depression at 3 months (51.8% vs. 37.8%; AD 14%, 95% CI 4.77 to 23.23).
Secondary outcomes
No significant difference in anxiety remission (62.7% vs. 50.2%; AD 12.5%, 95% CI -4.09 to 29.09).
Conclusion
In university students with anxiety and/or depression, clinician-guided iCBT was superior to self-guided iCBT with respect to joint remission of anxiety and depression at 3 months.
Reference
Corina Benjet, Nur Hani Zainal, Yesica Albor et al. A Precision Treatment Model for Internet-Delivered Cognitive Behavioral Therapy for Anxiety and Depression Among University Students: A Secondary Analysis of a Randomized Clinical Trial. JAMA Psychiatry. 2023 Aug 1;80(8):768-777.
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