Symptom heterogeneity in students with mild to severe depression symptomatology and their differential symptom-specific changes during an internet-based, guided cognitive behavioural therapy intervention

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2025-05-16 DOI:10.1016/j.invent.2025.100834

Lynn Boschloo , Jasmijn Wijnands , Nadia Garnefski , Vivian Kraaij , Petra Hurks , Danielle Remmerswaal , Reinout W. Wiers , Sascha Struijs , Elske Salemink

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引用次数: 0

Abstract

Background

Students often report depression and stress symptomatology but may differ in their symptoms and their symptom-specific changes during interventions. This study adopted a symptom-specific approach and examined 1) individual symptoms in students experiencing mild to severe depression symptomatology and 2) changes in individual symptoms during a guided, internet-based intervention. We zoomed in on how these (changes in) symptoms were related to each other and to (changes in) overall quality of life.

Methods

This study included 1816 students with mild to severe baseline depression symptomatology, of which 412 activated their account for an eight-week, guided, internet-based Cognitive Behavioural Therapy intervention (Moodpep) and completed the post-treatment assessment. Depression symptomatology was assessed with the Patient Health Questionnaire, stress symptomatology with the Perceived Stress Scale and overall quality of life with a single item from the Mental Health Quality of Life questionnaire. Network estimations were conducted to examine the interrelations of (changes in) symptoms.

Results

Mean scores of baseline symptoms differed substantially, and network estimations showed multiple positive connections across symptoms and negative connections of symptoms with overall quality of life. During the intervention, all symptoms reduced significantly, although with differential magnitude, and network estimations showed that changes in symptoms were differentially related to other changes in symptoms and changes in overall quality of life.

Conclusions

Our findings highlight the importance of considering individual symptoms and their interrelations as a more complete and nuanced measure for 1) the heterogeneity of baseline symptomatology and 2) the heterogeneity of changes in symptomatology during an intervention.

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在基于互联网的认知行为治疗干预中，轻至重度抑郁症学生症状的异质性及其差异症状特异性变化

背景：学生经常报告抑郁和压力症状，但在干预期间，他们的症状和症状特异性变化可能有所不同。本研究采用了一种症状特异性方法，并检查了1)经历轻度至重度抑郁症状的学生的个体症状，以及2)在指导的、基于互联网的干预过程中个体症状的变化。我们放大了这些症状（变化）是如何相互关联的，以及如何与整体生活质量（变化）相关的。方法本研究纳入了1816名有轻度至重度基线抑郁症状的学生，其中412人激活了他们的账户，进行了为期8周的基于网络的认知行为治疗干预（Moodpep），并完成了治疗后评估。抑郁症状用患者健康问卷进行评估，压力症状用感知压力量表进行评估，整体生活质量用心理健康生活质量问卷中的单项进行评估。进行网络估计以检查症状（变化）的相互关系。结果基线症状的平均得分存在显著差异，网络估计显示症状与整体生活质量之间存在多重正相关和负相关。在干预期间，所有症状都显著减轻，尽管程度不同，网络估计显示症状的变化与其他症状的变化和整体生活质量的变化存在差异。结论：我们的研究结果强调了考虑个体症状及其相互关系的重要性，作为1)基线症状的异质性和2)干预期间症状变化的异质性的更完整和细致的衡量标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions