JMIR Publications

ABSTRACT

Background:

Seventy percent of mental health problems appear before the age of 25 years and when untreated can become long-standing, and significant, impairing multiple life domains (1). Although the problem is especially acute for youth from First Nations backgrounds, all Canadian youth aged 15- to 25 years are highly likely to experience mental health disorders, substance dependencies and suicide. Progress in the treatment of youth that capitalizes on tendencies to respond to online contacts strategically addresses mental health problems, particularly depressive disorders.

Objective:

We will conduct a randomized controlled trial (RCT), to compare online mindfulness-based cognitive behavioural therapy combined with standard psychiatric care vs. psychiatric care alone (wait-list controls) in youth diagnosed with major depressive disorder. We will enrol N = 168 subjects in the age range of 18-30 years, 50% of whom will be from First Nations backgrounds and the other 50% from all other ethnic backgrounds, equally stratified in two intervention groups and two (wait-list) control groups (42 subjects per group, where INT1 and CTL1 are FN background, and INT2 and CTL2 are non-FN background).

Methods:

In this RCT, the primary outcome will be self-reported depression on the Beck Depression Inventory II. Secondary outcomes include anxiety (Beck Anxiety Inventory), depression (Quick Inventory of Depressive Symptomatology, 24-item Hamilton Rating Scale for Depression (HRSD-24)), pain (Brief Pain Inventory) and mindfulness (Five-Facet Mindfulness Questionnaire).

Results:

Recruitment/retention rates will be assessed with estimates for the proportion of participants with complete data per outcome and time points divided by the total number of study participants. Variability of the main and interaction effects will be examined in the primary clinical outcome and each secondary outcome using separate repeated measures ANCOVA models, with Bonferroni corrections applied to the models applied. Hedges' g and associated confidence intervals will be calculated as an estimate of the effect size both over time (within groups) and between groups. Missing data will be evaluated on a case-by-case basis such that drop-outs will be excluded.

Conclusions:

If results confirm hypotheses that youth can be effectively treated with online mindfulness-based cognitive behavioural therapy at reduced costs, effective services can be delivered more widely with less geographic restrictions. Clinical Trial: Clinical Trials.gov