A groundbreaking study published in The Lancet has revealed that a cognitive behavioural therapy (CBT) self-help mobile app may help prevent depression symptoms in young people at elevated risk.

The Emotional Competence for Wellbeing in the Young (ECoWeB) PREVENT trial, conducted across four European countries, provides compelling evidence for digital interventions' potential to promote mental health among vulnerable youth populations.

The ECoWeB PREVENT trial was an international, multicentre, parallel, open-label, randomized controlled trial conducted at UK, Germany, Spain, and Belgium university sites.

“The study aimed to test whether a personalized emotional competence self-help app could prevent the onset and increase of depression symptoms compared to a CBT self-help app and a self-monitoring app control.”

Participants and Methods

The trial recruited 1,262 young people aged 16-22 years who were identified as having an elevated risk for poor mental health based on their emotional competence profile. Participants were randomly assigned to one of three groups:

• Emotional competence app (417 participants)

• CBT app (423 participants)

• Self-monitoring app (422 participants)

All interventions were delivered through smartphone apps designed for iOS and Android platforms. The primary outcome measure was depression symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9) at 3-month follow-up.

Also read: The AI Coaching Breakthrough in ChatGPT

CBT App Shows Promising Results in Preventing Depression.

The study's most significant finding was that the CBT self-help app demonstrated beneficial protective effects compared to the self-monitoring control app.

At the 3-month follow-up: Depression symptoms were lower in the CBT app group compared to the self-monitoring app group (mean difference in PHQ-9: -1.18; 95% CI -2.01 to -0.34; p=0.006).

The CBT app group had a lower likelihood of meeting caseness for depression (31% vs 43% in the self-monitoring group; odds ratio 0.50; 95% CI 0.31 to 0.81).

Work or academic and social functioning and health-related quality-of-life were higher in the CBT app group compared to the self-monitoring group.

Emotional Competence App Results

Contrary to the researchers' hypotheses, the emotional competence app did not show significant benefits compared to the CBT or self-monitoring apps.

“The result suggests that the combination of training emotional competence skills and personalization within the app may not be as effective as initially thought.”

Long-Term Effects

While the CBT app showed promising results at three months, the benefits appeared to fade by the 12-month follow-up. This finding highlights the need for strategies to maintain engagement and the long-term effectiveness of digital interventions.

Also Read: See Through Skin: A New Era in Non-Invasive Imaging

Implications for Public Mental Health

The study's findings have significant implications for public mental health interventions targeting young people:

1. Scalable Intervention: The CBT self-help app, being automated and non-consumable, could be rolled out economically as a public mental health intervention.

2. Population-Level Impact: Although the individual effect size was modest, the potential for widespread implementation could yield a substantial impact at the population level.

3. Targeted Prevention: The study suggests that CBT self-help apps may be most beneficial for at-risk youth populations rather than as a universal intervention.

4. Cost-Effective Solution: With an estimated cost of £25 per user per year for setup and maintenance, the CBT app aligns with recommended intervention costs from health authorities.

Future research should focus on:

• Developing more sophisticated personalization algorithms

• Investigating ways to increase long-term app engagement

• Exploring the potential benefits of human support in conjunction with app-based interventions

• Expanding studies to more diverse populations

Also Read: Non-Antibiotic Therapies

The ECoWeB PREVENT trial provides valuable evidence for the potential of CBT self-help apps in preventing depression among at-risk youth. While the emotional competence app did not show the expected benefits, the CBT app demonstrated promising short-term effects in delaying the onset and increase of depression symptoms.

As digital mental health interventions evolve, this study underscores the importance of evidence-based approaches and the need for ongoing research to optimize their effectiveness and reach.

The findings of this trial open new avenues for accessible, scalable, and cost-effective mental health interventions for young people. As we navigate the challenges of promoting mental well-being in an increasingly digital world, studies like ECoWeB PREVENT provide crucial insights into the potential of technology to support mental health on a global scale.

The article is part of a research study published in The Lancet