{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:37:28Z","timestamp":1790969848157,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":329,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The COVID\u201019 pandemic exposed a substantial portion of society to multiple stressors, while access to mental health care was limited. To address this, we introduced a digital stepped\u2010care program rooted in cognitive\u2013behavioral therapy (CBT) principles, aiming to alleviate mental health distress among the general public seeking help.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The program comprises a 4\u2010week digital application using \u201cAury\u201d the chatbot, followed by an optional 6\u2010week online group session for those still symptomatic. A 4\u2010week waiting period separated these steps. Participants entered based on self\u2010identified mental health concerns. Interventions addressed prevalent pandemic mental health issues: sleep disturbances, anxiety, depression, worry\/rumination, interpersonal issues, and resource mobilization. Outcomes focused on depressive, anxiety, and somatic symptoms, assessed by the Patient Health Questionnaire (PHQ).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of the 1261 initial participants, postchatbot results (<jats:italic>N<\/jats:italic>\u2009=\u2009142) indicated small to medium effects (<jats:italic>d<\/jats:italic>\u2009=\u20090.412 to <jats:italic>d<\/jats:italic>\u2009=\u20090.523). Those finishing the entire program (<jats:italic>N<\/jats:italic>\u2009=\u200941) saw substantial symptom decline with medium to large effects (<jats:italic>d<\/jats:italic>\u2009=\u20090.757 to <jats:italic>d<\/jats:italic>\u2009=\u20090.818). No shifts were seen in the waiting phase. At follow\u2010up 6 months after baseline, both groups\u2014those who only used the chatbot (<jats:italic>N<\/jats:italic>\u2009=\u200960; <jats:italic>d<\/jats:italic>\u2009=\u20090.284 to <jats:italic>d<\/jats:italic>\u2009=\u20090.416) and those who completed the entire program (<jats:italic>N<\/jats:italic>\u2009=\u200927; <jats:italic>d<\/jats:italic>\u2009=\u20090.854 to <jats:italic>d<\/jats:italic>\u2009=\u20090.926)\u2014showed sustained symptom reduction. Comparing groups that received no intervention, used the chatbot only, and completed the entire program, we observed a dose\u2013response effect.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> This resource\u2010efficient and adaptable digital approach effectively reduced pandemic\u2010induced mental health issues, indicating its potential in crisis periods with limited health resources. Randomized controlled trials are recommended for further validation.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> Clinical Trial Registry identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/drks.de\/search\/en\/trial\/DRKS00023220\">DRKS00023220<\/jats:ext-link>.<\/jats:p>","DOI":"10.1155\/2024\/8950388","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T04:48:36Z","timestamp":1732596516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of a CBT\u2010Based Program for Mental Health in the General Population During the COVID\u201019 Pandemic: A Stepped\u2010Care Approach Using a Chatbot and Digitized Group 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