JMIR Publications

ABSTRACT

Background:

Rumination and worry are common risk factors of depression and anxiety. Internet-based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety.

Objective:

This study developed and compared the efficacy of two Internet-based transdiagnostic interventions with online guidance to an Internet-based psychoeducation control group in reducing risks and symptoms of depression and anxiety.

Methods:

This three-arm randomized controlled trial compared Internet-based rumination-focused cognitive behavioral therapy (RFCBT), mindfulness-based intervention (MBI), and psychoeducation control (EDU). A total of 256 participants were randomised into one of the three courses and received a 6-module program. Participants’ level of rumination, worry, depressive and anxiety symptoms were assessed at post-intervention (6 weeks), at 3-month and 9-month follow up. Efficacy was tested using Linear Mixed Model analysis.

Results:

Results showed similar levels of improvement on all outcomes across the three conditions. Change in rumination differed comparing RFCBT and MBI, where a fluctuation on rumination was noted at 3-month follow up among participants in RFCBT and an absence of long-term effect on was noted among participants in MBI at 9-month follow up.

Conclusions:

All three conditions showed similar reduction in risks and symptoms implied that the two active interventions were not superior to psychoeducation control. The high attrition at follow-ups suggested the need for caution concerning the findings. Future studies should tease apart placebo effect and identify ways to improve adherence. Clinical Trial: Chinese Clinical Trial Registry (Trial no: ChiCTR-IOR-15006470)