Effectiveness Study of a Cultural Adaptation of Cognitive-Behavioural Therapy-Based Application for Depressive Symptoms in College Students: A Randomised Controlled Trial

Introduction: Studies on mental health applications among college students lack empirical evidence regarding mobile application usage's intensity, duration and frequency.

Aim: To evaluate the effectiveness of a cognitive-behavioural therapy (CBT)-based mobile application in ameliorating depressive symptoms among college students.

Methods: A randomised controlled trial was conducted at three universities. Undergraduates aged ≥ 20 years with self-reported depressive symptoms were recruited and randomly assigned to the control and intervention groups. The outcomes include changes in depressive symptoms, suicidal ideation, help-seeking attitudes and emotional self-awareness at 4 (T1), 8 (T2) and 12 (T3) weeks. An intention-to-treat analysis was conducted.

Results: Of the 91 participants, 46 in the intervention group exhibited a significant decline in depressive symptoms at T1 and lower patterns of symptom changes at T2 and T3. No significant differences were observed in the other outcomes; however, higher help-seeking attitude, emotional self-awareness and lower suicidal ideation after T0 were observed for those who used the application for 12 weeks.

Discussion: The advantages of a brief application-based intervention to promote college students' psychological health are outlined.

Implications: School nursing managers could use the application to improve the college mental health systems and support collegial teacher-student relationships.

Recommendations: Further studies should enhance application usage to manage depressive symptoms.

Trial registration: The study was approved by the Research Ethics Committee of the National Taiwan University Hospital (No. 202108098RINB, Date of approval: Oct 27, 2021) and the National Institutes of Health (No. NCT05188950).