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

doi:10.2196/24380

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

J Med Internet Res. 2021 Mar 10;23(3):e24380. doi: 10.2196/24380.

Authors

Paul Ritvo^{1

2

3}, Yuliya Knyahnytska^{3

4

5}, Meysam Pirbaglou¹, Wei Wang^{4

5}, George Tomlinson^{6

7}, Haoyu Zhao^{3

4

5}, Renee Linklater^{4

8}, Shari Bai^{4

5}, Megan Kirk¹, Joel Katz^{1

9}, Lillian Harber⁴, Zafiris Daskalakis^{3

5

10

11}

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.

PMID: 33688840
PMCID: PMC7991990
DOI: 10.2196/24380

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.

©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.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cognitive Behavioral Therapy*
Depressive Disorder, Major* / therapy
Humans
Internet-Based Intervention*
Mindfulness*
Surveys and Questionnaires
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT03406052

Grants and funding

CIHR/Canada