Background: Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened the population's mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioral therapy (e-CBT) is a cost-effective and evidence-based treatment for anxiety and depression and can be accessed remotely.
Objective: The objective of the study was to investigate the efficacy of online psychotherapy tailored to depression and anxiety symptoms during the pandemic.
Methods: The pilot study used a pre-post design to evaluate the efficacy of a 9-week e-CBT program designed for individuals with depression and anxiety affected by the pandemic. Participants were adults (N=59) diagnosed with major depressive disorder and generalized anxiety disorder, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed.
Results: Participants demonstrated significant improvements in symptoms of anxiety (P=.02) and depression (P=.03) after the intervention. Similar trends were observed in the intention-to-treat analysis. No significant differences were observed in resilience and quality-of-life measures. The sample comprised mostly females, making it challenging to discern the benefits of the intervention in males. Although a pre-post design is less rigorous than a controlled trial, this design was selected to observe changes in scores during a critical period.
Conclusions: e-CBT for COVID-19 is an effective and accessible treatment option. Improvements in clinical symptoms of anxiety and depression can be observed in individuals whose mental health is affected by the COVID-19 pandemic.
Trial registration: ClinicalTrials.gov NCT04476667; https://clinicaltrials.gov/study/NCT04476667.
International registered report identifier (irrid): RR2-10.2196/24913.
Keywords: COVID-19; anxiety; cognitive behavioral therapy; depression; efficacy; electronic cognitive behavioral therapy; evidence-based treatment; mental health; online; online psychotherapy tool; pandemic.
©Elnaz Moghimi, Callum Stephenson, Anika Agarwal, Niloofar Nikjoo, Niloufar Malakouti, Gina Layzell, Anne O'Riordan, Jasleen Jagayat, Amirhossein Shirazi, Gilmar Gutierrez, Ferwa Khan, Charmy Patel, Megan Yang, Mohsen Omrani, Nazanin Alavi. Originally published in JMIR Mental Health (https://mental.jmir.org), 25.12.2023.