The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial

Abstract

Background The prevalence of depressive and anxiety symptoms in patients with COVID-19 is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was needed. Cognitive behavioral therapy (CBT) is the first-line psychological therapy in clinical treatment. Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response. Objective This study aims to evaluate the efficacy of the cCBT program we developed in improving depressive and anxiety symptoms among patients with COVID-19. Methods We customized a cCBT program focused on improving depressive and anxiety symptoms among patients with COVID-19, and then, we assessed its effectiveness. Screening was based on symptoms of depression or anxiety for patients who scored ≥7 on the Hamilton Depression Rating Scale (HAMD17) or the Hamilton Anxiety Scale (HAMA). A total of 252 patients with COVID-19 at five sites were randomized into two groups: cCBT + treatment as usual (TAU; n=126) and TAU without cCBT (n=126). The cCBT + TAU group received the cCBT intervention program for 1 week. The primary efficacy measures were the HAMD17 and HAMA scores. The secondary outcome measures were the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Athens Insomnia Scale (AIS). Assessments were carried out pre- and postintervention. The patients’ symptoms of anxiety and depression in one of the centers were assessed again within 1 month after the postintervention assessment. Results The cCBT + TAU group displayed a significantly decreased score on the HAMD17, HAMA, SDS, SAS, and AIS after the intervention compared to the TAU group (all P<.001). A mixed-effects repeated measures model revealed significant improvement in symptoms of depression (HAMD17 and SDS scores, both P<.001), anxiety (HAMA and SAS scores, both P<.001), and insomnia (AIS score, P=.002) during the postintervention and follow-up periods in the cCBT + TAU group. Additionally, the improvement of insomnia among females (P=.14) and those with middle school education (P=.48) in the cCBT + TAU group showed no significant differences when compared to the TAU group. Conclusions The findings of this study suggest that the cCBT program we developed was an effective nonpharmacological treatment for symptoms of anxiety, depression, and insomnia among patients with COVID-19. Further research is warranted to investigate the long-term effects of cCBT for symptoms of anxiety, depression, and insomnia in patients with COVID-19. Trial Registration Chinese Clinical Trial Registry ChiCTR2000030084; http://www.chictr.org.cn/showprojen.aspx?proj=49952

Online Affirmation and Peer Support are Effective for Reducing Medical Personnel Stress in Dealing with Covid-19 Patients

“…This therapy is free of charge, requires no special place or equipment, and does not require professional guidance. Thus this therapy is easy and comfortable to do (Zainiyah et al, 2018;Li et al, 2020;Liu et al, 2021)diarrhea and insomnia. One of stressmanagement is affirmation relaxation (AR.…”

Efetividade da Terapia Cognitivo-Comportamental on-line no cenário de pandemia da COVID-19: Uma revisão sistemática

“…Only one of them was conducted in 2020 (Wahlund et al, 2020). Three of them were conducted in Middle Eastern countries (Al-Alawi et al, 2021;Shapira et al, 2021;Shaygan et al, 2021), three on the European continent (Perri et al, 2021;Preuss et al, 2021;Wahlund et al, 2020) and one in Asia (Liu et al, 2021).…”

“…The study outcomes were quite heterogeneous. In the studies by Al-Alawi et al (2021) and Liu et al (2021), anxiety and depression were the primary outcomes analyzed; depression, combined with loneliness, were evaluated in the study by Shapira et al (2021); and dysfunctional concerns (an important component for understanding anxiogenic conditions) were analyzed in the protocol by Wahlund et al (2020). The instruments were mostly scales and (Liu et al, 2021;Shapira et al, 2021;Shaygan et al, 2021).…”

“…Except for Shaygan et al (2021), whose results revealed a significant improvement in the resilience outcome. Liu et al (2021), Perri et al (2021), andWahlund et al (2020) evaluated the follow-up one month after the end of the interventions, suggesting maintenance of the effects.…”

Copyright as a Barrier to Music Therapy Telehealth Interventions: Qualitative Interview Study

“…Preliminary research suggests music therapy via telehealth improves access to care and community music engagement [14,15]. Research also suggests web-based services are promising avenues to increase mental health awareness and treatment options [16,17]. For those practicing via mediated technologies, there are several freely available and fee-based platforms to choose from, including Doxy.me (Doxy.me LLC, Rochester, NY), Microsoft Teams (Microsoft Corporation, Redmond, WA), Skype for Business (Microsoft Corporation), WebEx (Webex by Cisco, Milpitas, CA), and Zoom (Zoom Video Communications Inc, San Jose, CA).…”