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

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Studies on mental health applications among college students lack empirical evidence regarding mobile application usage's intensity, duration and frequency. To evaluate the effectiveness of a cognitive-behavioural therapy (CBT)-based mobile application in ameliorating depressive symptoms among college students. 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. 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. The advantages of a brief application-based intervention to promote college students' psychological health are outlined. School nursing managers could use the application to improve the college mental health systems and support collegial teacher-student relationships. Further studies should enhance application usage to manage depressive symptoms. 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).