{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:17:53Z","timestamp":1773415073867,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22K11012"],"award-info":[{"award-number":["JP22K11012"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018117","name":"Aichi Health Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim was to explore the preventive effects of smartphone cognitive behavioral therapy (CBT) in addressing depression and anxiety in patients with recurrent pregnancy loss (RPL) due to lack of such previous studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was an exploratory decentralized, parallel\u2010group, multicenter, open, individually randomized, fully factorial trial. A total of 432 patients with RPL were randomized and patients who completed the psychoeducation component of the app within 2\u2009weeks of consent were included. Five CBT components\u2014namely, self\u2010monitoring, behavioral activation, cognitive restructuring, assertion training, and problem solving\u2014were randomly assigned as present or absent, resulting in 2\n                      <jats:sup>5<\/jats:sup>\n                      \u2009=\u200932 combinations. The primary outcomes were changes in Patient Health Questionnaire\u20109 and Generalized Anxiety Disorder\u20107 scores at weeks 8 and 12 from baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 419 patients were analyzed. The presence or absence of specific CBT components did not significantly affect patient outcomes. However, patients experienced a statistically significant overall reduction in depressive symptoms from baseline to weeks 8 and 12. Pre\u2013post effect sizes for overall improvement ranged from \u22120.30 to \u22120.38 at week 8 and from \u22120.22 to \u22120.33 at week 12. No significant overall reduction in anxiety symptoms was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The CBT application significantly reduced depressive symptoms in patients with RPL; however, no specific CBT component showed superior effects. The findings did not indicate efficacy in comparison to the pure treatment\u2010as\u2010usual group. Further research is required to enhance its impact on anxiety and refine the selection and delivery of individual CBT components.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70001","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T12:42:48Z","timestamp":1764592968000},"page":"180-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone cognitive behavioral therapy for prevention of depressive symptoms in patients with recurrent pregnancy loss: an exploratory decentralized, parallel\u2010group, multicenter, open, individually randomized, fully factorial trial"],"prefix":"10.1111","volume":"80","author":[{"given":"Sakura","family":"Ogasawara","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Ashio","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayano","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Banno","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinobu","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamao","family":"Kitaori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"},{"name":"Aoki Ladies Clinic  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisashi","family":"Noma","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Statistical Mathematics The Institute of Statistical Mathematics  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshi A.","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Office of Institutional Advancement and Communications Kyoto University  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-377X","authenticated-orcid":false,"given":"Mayumi","family":"Sugiura\u2010Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00682-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/aji.13072"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des179"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s10038-019-0694-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2006.11.007"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540290035029"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2012.745490"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/01674820209074668"},{"key":"e_1_2_9_10_1","first-page":"330","volume-title":"Depression. 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