The effect for Japanese workers of a self-help computerized cognitive behaviour therapy program with a supplement soft drink

Abstract

BackgroundComputerized cognitive behaviour therapy (CCBT) programs can provide a useful self-help approach to the treatment of psychological problems. Previous studies have shown that CCBT has moderate effects on depression, insomnia, and anxiety. The present study investigated whether a supplement drink that includes L-carnosine enhances the effect of CCBT on psychological well-being.MethodsEighty-seven participants were randomly allocated to a control group, CCBT, or CCBT with supplement drink. The CCBT and CCBT with supplement drink groups received six weekly self-help CCBT program instalments, which consisted of psycho-education about stress management and coping, behaviour activation, and cognitive restructuring. The CCBT group consumed a bottle of the supplement soft drink every morning through the 6 weeks. This program was delivered by an e-learning system on demand and also included a self-help guidebook. Seventy-two participants completed the program or were assess at the end of the study.ResultsANOVA revealed that there were significant interactions (times × groups) for POMS tension-anxiety and fatigue. The CCBT group showed significantly improved tension-anxiety scores, whereas the CCBT with drink group showed significant improvements on fatigue.ConclusionThe self-help CCBT program reduced the subjective experience of tension-anxiety in this group of workers. The addition of a supplement drink enhanced the effect of CCBT on fatigue, providing one possible approach to enhancement of such programs.Trial registrationThis study was registered on September 2, 2016 at UMIN. The registration number is UMIN000023903.

L-carnosine as an enhancer to computerized cognitive behaviour therapy in Japanese workers, an unjustified claim

“…We thought important to remind the reader about the context in which this experimental research took place, given the high threat to internal validity caused by the well documented investigators’ bias as well as the subjects’ and participation biases [ 2 – 4 ], making the quality of this study low as per the Cochrane Risk of Bias Tool for Randomized Controlled Trials ([ 5 ], Table 8.5.d). More precisely, in Shirotsuki et al’s study [ 1 ], we found a high risk of bias in selective reporting, incomplete outcome data, and blinding of participants and outcome assessment, meaning that conclusions of such low quality studies must be cautiously taken.…”

“…Nevertheless, these limits remain highly threatening to the internal validity and our questions relative to what looks like serious methodological shortcomings should lead to only one conclusion: the study of Shirotsuki, et al [1] should be re-conducted before any valid conclusion could be drawn.…”

“…Shirotsuki et al’s study [ 1 ] assessed whether the intake of a carbonated drink containing L-carnosine increases the effects of a computerized cognitive-behavioural therapy (CCBT) on psychological well-being of healthy Japanese workers. To achieve their goal, the authors conducted a randomized-controlled trial with three groups: an experimental group ( n = 29) receiving the dietary supplement in combination with the CCBT, a first control group (n = 29) receiving only CCBT, and a second control group (n = 29) receiving neither of the two forms of intervention.…”

The Potential of Carnosine in Brain-Related Disorders: A Comprehensive Review of Current Evidence

“…Two interesting trials have examined the effects of carnosine on various aspects of behaviour, literacy-related skills, and mood. A Japanese trial in 87 healthy office workers [195] showed that a supplement drink containing carnosine (200 mg daily) along with a computerized cognitive behavioural therapy program reduced self-reported tension and anxiety compared to the placebo. Another RCT in Finland investigated the effects of a supplement containing carnosine on literacy-related skills in children [196].…”

“…Only two weeks of supplementation with L-histidine (1.65 g daily) improved fatigue scores in men with chronic fatigue syndrome [173]. Similarly, two weeks of supplementation with another carnosine precursor, β-alanine, improved resistance against fatigue during sustained military operation in recreationally active adults [175] and a drink containing carnosine together with a computerized cognitive behavioural therapy program reduced self-reported fatigue in office workers [195].…”