{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T17:53:08Z","timestamp":1774288388865,"version":"3.50.1"},"reference-count":47,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: This study evaluated the effectiveness of blended cognitive behavioral therapy (bCBT) with a digital health application (elona therapy) compared to standard cognitive behavioral therapy (CBT) for unipolar depression in outpatient care. Methods: This multicenter, randomized, two-arm controlled trial recruited 283 adult patients with unipolar depression in Germany. Patients were randomized to receive either standard face-to-face CBT combined with the digital health application (bCBT group) or standard face-to-face CBT alone. Symptoms of depression and anxiety, along with other patient-related characteristics, were assessed at baseline (T0: week 0) and post-intervention (T1: week 12). Results: Patients in the bCBT group showed greater improvements in depressive symptoms (primary outcome: d = 0.62, p &lt; 0.001), anxiety (d = 0.61, p &lt; 0.001), quality of life (d = 0.42, p &lt; 0.001), perceived self-efficacy (d = 0.41, p = 0.003), depression literacy (d = 0.66, p &lt; 0.001) and overall disease severity outcomes (d = 0.45\u20130.60, ps &lt; 0.005) compared with patients in the CBT group. Conclusion: This study provides evidence supporting the effectiveness of bCBT in patients diagnosed with unipolar depressive disorder across a broad range of clinically relevant outcomes. 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