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Medscape

Can Digital Therapy Improve Mental Health Among Teens?

TOPLINE: In a randomised trial of adolescents with mental health issues, the use of a 6-week online emotion-regulation therapy was found to be feasible and acceptable. Compared with an active control therapy, this online therapy significantly alleviated symptoms of anxiety, depression, and maladaptive coping. METHODOLOGY: This single-blind randomised clinical trial conducted between 2022 and 2023 in Swedish primary care included 30 adolescents aged 12-17 years (93% girls) with mental health problems and their parents. Participants were randomly assigned to receive 6 weeks of either therapist-guided primary care online emotion-regulation treatment (POET; n = 15) or supportive treatment (n = 15) as an active control. Primary outcomes included feasibility and acceptability; secondary outcomes included symptom severity and improvement (measured using the Clinical Global Impressions-Severity Scale [CGI-S] and CGI-Improvement Scale), symptoms of anxiety and depression (measured using the Revised Child Anxiety and Depression Scale [RCADS-47]), global functioning (measured using the Children's Global Assessment Scale [CGAS]), and emotion regulation (measured using the Cognitive Emotion Regulation Questionnaire [CERQ]). Outcomes were self-reported online or obtained via telephonic interviews immediately after treatment and at a 3-month follow-up. TAKEAWAY: The study had a consent rate of 81%, with 93% of participants completed at least one assessment immediately after treatment and 87% completed 3-month follow-up assessments. Treatment satisfaction was high among both adolescents (mean Client Satisfaction Questionnaire-8 [CSQ-8] score: POET, 20.6; supportive treatment, 22.8) and parents (mean CSQ-8 score: POET, 24.8; supportive treatment, 23.1). When comparing before and immediately after treatment, the POET group showed significant reductions in symptom severity (CGI-S: effect size, 1.30; 95% CI, 0.73-1.86), symptoms of anxiety and depression (RCADS-47: Cohen d, 1.07; 95% CI, 0.37-1.84), and maladaptive cognitive coping (CERQ: Cohen d, 1.10; 95% CI, 0.52-1.70), as well as improvement in global functioning (CGAS: Cohen d, 1.26; 95% CI, 0.66-1.85). The control group showed no significant differences. When comparing before treatment and at 3 months post-treatment, the POET group maintained reductions in symptom severity (CGI-S: effect size, 1.32; 95% CI, 0.76-1.88), symptoms of anxiety and depression (RCADS-47: Cohen d, 1.28; 95% CI, 0.51-2.08), and maladaptive cognitive coping (CERQ: Cohen d, 0.82; 95% CI, 0.22-1.40), as well as improvement in global functioning (CGAS: Cohen d, 1.54; 95% CI, 0.95-2.14). The control group showed no significant differences. IN PRACTICE: "Given that adolescents represent a large patient group with limited access to psychological treatment, these findings suggest that POET is a promising treatment in primary care, with the potential for broad outreach and improved accessibility for adolescents with mental health problems," the authors wrote. SOURCE: This study was led by Katja Sjöblom, MSc, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden. It was published online on June 11 in JAMA Network Open. LIMITATIONS: A small sample size and lack of stratification in the randomisation procedure prevented the between-group analysis of effectiveness. Most participants were self-referred, potentially introducing selection bias. The active control study design limited clinical interpretation compared with a control group using treatment as usual or gold standard treatment. DISCLOSURES: This study was supported by grants from the Kavli Trust, Region Stockholm, and the Swedish Research Council. Several authors reported receiving grants, royalties, and personal fees from various academic, governmental, and private sources, and one author reported holding shares in companies outside the submitted work. Details are provided in the original article. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.