{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:02:19Z","timestamp":1787612539457,"version":"build-2736575974"},"reference-count":40,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"abstract":"<jats:sec id=\"S0007125026106308_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Major depression is a common and disabling disorder, and individuals with subthreshold depression represent a key at-risk group. We previously demonstrated that specific cognitive behavioural therapy (CBT) skills training delivered via a smartphone app (behavioural activation, cognitive restructuring, problem solving, assertion training and behavioural therapy for insomnia) improved depressive symptoms for up to 26 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106308_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the long-term effects (up to 50 weeks) of CBT skills and their combinations for preventing major depressive episodes and reducing the total burden of depression (TBD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106308_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Participants were adults from the general population with subthreshold depression. A master protocol trial with four 2 \u00d7 2 factorial trials was used to randomise 3280 participants to one of nine intervention arms or a self-check control group. The primary outcome was time to onset of major depression by week 50.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106308_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hazard ratios for the interventions ranged from 0.52 (95% CI: 0.29\u20130.94) to 0.63 (95% CI: 0.36\u20131.10), with behavioural activation + assertion training showing the greatest preventive effect (number needed to treat: 23.3 (95% CI: 12.2 to 250)), followed by behavioural therapy for insomnia, behavioural activation + behavioural therapy for insomnia and cognitive restructuring. All interventions reduced TBD scores compared with control, with behavioural activation + cognitive restructuring exhibiting the largest reduction. Effect sizes at week 50 ranged from \u22120.34 to \u22120.07 and behavioural activation + cognitive restructuring was the most effective. No serious adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125026106308_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current findings indicated that specific CBT skills \u2013 particularly behavioural activation +assertion training , behavioural activation + cognitive restructuring and behavioural therapy for insomnia \u2013 effectively prevented the onset of depression and reduced the TBD at 50 weeks. Given its brevity, portability, accessibility and scalability, smartphone-based CBT is promising as a preventive intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2026.10630","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T07:00:52Z","timestamp":1780297252000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive and behavioural skills to prevent major depression among adults with subthreshold depression: 50-week follow-up analysis of smartphone CBT randomised trials (RESiLIENT trial)"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-7518","authenticated-orcid":false,"given":"Tatsuo","family":"Akechi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04wn7wc95","id-type":"ROR","asserted-by":"publisher"}],"name":"Nagoya City University Graduate School of Medical Sciences and Medical 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}