Digital Cognitive Behavioral Therapy for Chinese Adolescents with Depressive Symptoms (CADS-D): protocol for a randomized controlled trial.

Abstract

Background: Previous studies have confirmed that digital cognitive behavioral therapy (dCBT) is an effective intervention for alleviating depressive symptoms. However, there are no specific dCBT programs available for Chinese adolescents. Therefore, we developed a smartphone-based cognitive behavioral therapy program. This study aims to evaluate the efficacy and feasibility of dCBT for Chinese adolescents with depressive symptoms.

Methods: The Digital Cognitive Behavioral Therapy for Chinese Adolescents with Depressive Symptoms (CADS-D) study is a single-center, two-arm, open-label randomized controlled trial. A total of 200 adolescents aged 12-18 years with depressive symptoms will be recruited. Key exclusion criteria include severe depressive symptoms or suicide risk, comorbid psychiatric disorders other than depressive disorders, severe physical illness or disability preventing dCBT use, current or recent treatment for depression, and inability to complete follow-up. Participants will be randomly assigned to either the intervention group, receiving the 6-week dCBT program MOCA, or the control group, receiving the regular school mental health curriculum. Assessments will be conducted at baseline (T1), post-intervention at week 6 (T2), and at a 3-month follow-up at week 18 (T3). The primary outcome is the change in depressive symptom severity from T1 to T2. Secondary outcomes, assessed at both T2 and T3, include feasibility and changes from baseline in self-reported depressive symptoms, anxiety symptoms, psychological resilience, and quality of life enjoyment and satisfaction. The first participant was enrolled in May 2025, and the study is currently ongoing.

Discussion: Findings from the CADS-D trial will provide empirical evidence regarding the efficacy and feasibility of dCBT among Chinese adolescents. If dCBT proves effective in alleviating depressive symptoms in adolescents, it will enhance therapeutic access for a wider adolescent population in China.

Trial registration: The study was registered with ClinicalTrials.gov (NCT07163013; https://clinicaltrials.gov/study/NCT07163013 ) on 9 September 2025.