Efficacy of Internet-based rumination-focused cognitive behavioral therapy and mindfulness-based intervention with guided support in reducing risks of depression and anxiety: A randomized controlled trial (Preprint)

Abstract

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.

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.

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 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.

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.

Chinese Clinical Trial Registry (Trial no: ChiCTR-IOR-15006470)