Efficacy of a Transdiagnostic Self-Help Internet Intervention for Reducing Depression, Anxiety, and Suicidal Ideation in Adults: Randomized Controlled Trial

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Low-intensity self-guided mental health interventions that are delivered online may meet the needs and preferences of adults with mild to moderate symptoms. However, there are few clinical trials examining the effectiveness of self-guided transdiagnostic interventions within a naturalistic setting. Objective: This randomised controlled trial (RCT) tested the effectiveness of the video-based transdiagnostic intervention FitMindKit in reducing depression symptoms (primary outcome), anxiety symptoms, disability and suicidal ideation, relative to an attention-matched control condition called HealthWatch. Methods: The RCT was conducted with adults living in the Australian Capital Territory, Australia. Participants (n=1,986) were recruited online using social media advertisements, screened for psychological distress, and then randomised to receive one of two 4-week programs: FitMindKit (12-module psychotherapy intervention) or HealthWatch (12-module program providing general health information). Participants were assessed at baseline and 4 weeks post-baseline. To maintain the ecological validity of the trial, participants completed brief assessments and the interventions without direct researcher contact or incentives. Results: Mixed model repeated measures ANOVA demonstrated that FitMindKit significantly improved depression symptoms (F1,701.7=3.97, p=.047), along with panic symptoms (F1,706.5=5.59, p=.018) and social anxiety symptoms (F1,680.0=12.37, p<.001) relative to the attention control condition. There were no significant effects on other outcomes. Conclusions: Self-guided transdiagnostic interventions can be beneficial when delivered directly to end-users through the internet. Despite low adherence and small effect sizes, the availability of such interventions is likely to fill a critical gap in the accessibility of mental health services for the community. Clinical Trial: This trial was registered with the Australian New Zealand Clinical Trials Registry (number ACTRN12618001688270)