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Transdiagnostic and tailored internet intervention to improve mental health among university students: Research protocol for a randomized controlled trial
Department of Psychology, Uppsala University, Uppsala, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Psychology, Stockholm University, Stockholm, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
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2024 (English)In: Trials, E-ISSN 1745-6215, Vol. 25, no 1, article id 158Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Emerging adulthood is often associated with mental health problems. About one in three university students report symptoms of depression and anxiety that can negatively affect their developmental trajectory concerning work, intimate relationships, and health. This can interfere with academic performance, as mood and anxiety disorders are key predictors of dropout from higher education. A treatment gap exists, where a considerable proportion of students do not seek help for mood and anxiety symptoms. Offering internet interventions to students with mental health problems could reduce the treatment gap, increase mental health, and improve academic performance. A meta-analysis on internet interventions for university students showed small effects for depression and none for anxiety. Larger trials are recommended to further explore effects of guidance, transdiagnostic approaches, and individual treatment components.

METHODS: This study will offer 1200 university students in Sweden participation in a three-armed randomized controlled trial (RCT) evaluating a guided or unguided transdiagnostic internet intervention for mild to moderate depression and anxiety, where the waitlist control group accesses the intervention at 6-month follow-up. Students reporting suicidal ideation/behaviors will be excluded and referred to treatment within the existing healthcare system. An embedded study within the trial (SWAT) will assess at week 3 of 8 whether participants in the guided and unguided groups are at higher risk of failing to benefit from treatment. Those at risk will be randomized to an adaptive treatment strategy, or to continue the treatment as originally randomized. Primary outcomes are symptoms of depression and anxiety. Follow-ups will occur at post-treatment and at 6-, 12-, and 24-month post-randomization. Between-group outcome analyses will be reported, and qualitative interviews about treatment experiences are planned.

DISCUSSION: This study investigates the effects of a transdiagnostic internet intervention among university students in Sweden, with an adaptive treatment strategy employed during the course of treatment to minimize the risk of treatment failure. The study will contribute knowledge about longitudinal trajectories of mental health and well-being following treatment, taking into account possible gender differences in responsiveness to treatment. With time, effective internet interventions could make treatment for mental health issues more widely accessible to the student group.

Place, publisher, year, edition, pages
Springer Nature, 2024. Vol. 25, no 1, article id 158
Keywords [en]
Anxiety, Depression, Internet intervention, Tailored intervention, Transdiagnostic intervention, University
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:mau:diva-66568DOI: 10.1186/s13063-024-07986-1PubMedID: 38429834Scopus ID: 2-s2.0-85186567766OAI: oai:DiVA.org:mau-66568DiVA, id: diva2:1847650
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-03-28Bibliographically approved

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Andersson, Claes

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