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Introduction: Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. Objective: This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). Methods: Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. Results: Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. Conclusions: A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives. [ABSTRACT FROM AUTHOR]

Background: Research on the effectiveness of treatments for subthreshold depression (sD) is still scarce. The aim of the study was to evaluate the efficacy of a web-based guided self-help intervention (GET.ON Mood Enhancer) in the treatment of sD.Methods: Participants with sD (n = 406) recruited from the general population via a large health insurance company were randomly allocated to a web-based cognitive behavioural intervention or to enhanced care-as-usual. The primary outcome was the reduction in depressive symptom severity as measured with the Center for Epidemiological Studies Depression Scale at post-treatment and at 6-month follow-up.Results: Participants in the intervention group showed a significantly greater pre-post reduction in depressive symptom severity (d = 1.06; 95% CI: 0.86-1.27) compared to the control condition (d = 0.29; 95% CI: 0.10-0.49). The corresponding between-group effect size was d = 0.69 (95% CI: 0.49-0.89). At 6-month follow-up the effect was reduced to d = 0.28 (95% CI: 0.09-0.48) but was still statistically significant (F1, 403 = 9.240, p = 0.003).Conclusions: This study lends support to the idea that problem solving coupled with behavioural activation is an effective treatment for sD. In addition, the delivery of this intervention over the Internet might be a promising strategy for the dissemination of psychological interventions for sD on a large scale. [ABSTRACT FROM AUTHOR]

Background: Deficits in emotion regulation skills are possible factors maintaining major depressive disorder (MDD). Therefore, the aim of the study was to test whether integrating a systematic emotion regulation training (ERT) enhances the efficacy of routine inpatient cognitive behavioral therapy (CBT) for MDD. Methods: In a prospective randomized controlled trial, 432 inpatients meeting criteria for MDD were assigned to receive either routine CBT or CBT enriched with an intense emotion regulation skills training (CBT-ERT). Results: Participants in the CBT-ERT condition demonstrated a significantly greater reduction in depression (response rates - CBT: 75.5%, CBT-ERT: 84.9%; remission rates - CBT: 51.1%, CBT-ERT: 65.1%). Moreover, CBT-ERT participants demonstrated a significantly greater reduction of negative affect, as well as a greater increase of well-being and emotion regulation skills particularly relevant for mental health. Conclusions: Integrating strategies that target emotion regulation skills improves the efficacy of CBT for MDD. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Blended psychotherapy (bPT) is a treatment that integrates internet- and mobile-based interventions into out-/inpatient psychotherapy. It can enrich the therapy by using online-based treatment modules as therapeutic extension that patients use time- and location-independently between face-to-face sessions. It could potentially improve the efficacy of psychotherapy and increase the number of treated persons through saved therapist time. The case report aims to facilitate the understanding of the blended treatment components. Case Report: A 4-month short-time depression treatment with six face-to-face therapy sessions, six online lessons, and app ratings of a 48-year-old female patient is presented based on the CARE guidelines and quantitative and qualitative measures (treatment documentation). Depressive symptoms were clinically significantly reduced (PHQ-9, 0–27: T0 = 17; T1 = 7) from a moderately severe to a subclinical-mild degree, and no diagnostic criteria were met in the 12-month follow-up diagnostic interview. The patient showed a maximum treatment satisfaction (ZUF-8, 8–32: T1 = 32) and adherence and rated the therapeutic working alliance (WAI, 12–60: T1 = 57) highly positive. Conclusion: bPT reduced depressive symptoms for this patient. Strengths of the treatment were the facilitated use of the internet-based elements with a full-time job and the individualization within the face-to-face sessions through the therapist. Treatment success was limited by the predetermined six sessions, which hindered addressing all topics and conducting relapse prevention. [ABSTRACT FROM AUTHOR]