Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 13, 2023
Date Accepted: Aug 4, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Efficacy of a Text-based Mental Health Coaching Application in Improving Symptoms of Stress, Anxiety and Depression: A Randomized Controlled Trial
ABSTRACT
Background:
Stress, anxiety and depression are major mental health concerns worldwide. A wide variety of digital mental health interventions have demonstrated efficacy in improving one’s mental health status, and digital interventions that involve some forms of human involvement have been shown to demonstrate greater efficacy than self-guided digital interventions. Studies demonstrating the efficacy of digital mental health interventions within the Asian region are scarce.
Objective:
The current study aimed to investigate the potential efficacy of an asynchronous text-based digital mental health mobile application, ThoughtFullChat, in improving self-reported symptoms of depression, anxiety and stress. The study also aimed to look at potential differences in efficacy between occupational subgroups and gender.
Methods:
A cross-sectional study was conducted among housemen (trainee medical doctors), students, faculty members and corporate staff at International Medical University (IMU), Malaysia. 392 participants were enrolled and randomised to the intervention and control groups. Depression, anxiety, and stress symptoms were measured using the DASS-21 scale at baseline and after a 3-month intervention period. Other measures of life satisfaction and resilience were also included, along with a questionnaire on demographics.
Results:
A significant decrease was observed in depression (P=.015) and anxiety (P=.002) scores in the intervention group. One subgroup (corporate staff) also demonstrated a significant decrease in stress scores (P =.005) alongside depression (P=.006) and anxiety (P=.002). In our subgroup analysis, the corporate staff showed significantly greater improvements in depression, anxiety, and stress scores. Females showed significant improvements in depression (P=.024) and anxiety (P<.001) when compared to males.
Conclusions:
This study provides evidence that the ThoughtFullChat application is effective in improving symptoms of depression, anxiety, and stress in individuals, particularly among corporate staff. Mobile mental health applications that connect users to mental health professionals in a discreet and cost-efficient manner can make important contributions to the improvement of mental health outcomes. Clinical Trial: The study was registered on clinicaltrials.gov (ID: NCT04944277).
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