{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:55:38Z","timestamp":1782845738242,"version":"3.54.5"},"reference-count":60,"publisher":"JMIR Publications Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>About 70% of all mental health disorders appear before the age of 25 years. When untreated, these disorders can become long-standing and impair multiple life domains. When compared with all Canadian youth (of different ages), individuals aged between 15 and 25 years are significantly more likely to experience mental health disorders, substance dependencies, and risks for suicidal ideation and death by suicide. Progress in the treatment of youth, capitalizing on their online responsivity, can strategically address depressive disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We will conduct a randomized controlled trial to compare online mindfulness-oriented cognitive behavioral therapy (CBT-M) combined with standard psychiatric care versus psychiatric care alone in youth diagnosed with major depressive disorder. We will enroll 168 subjects in the age range of 18 to 30 years; 50% of subjects will be from First Nations (FN) backgrounds, whereas the other 50% will be from all other ethnic backgrounds. There will be equal stratification into 2 intervention groups (INT1 and INT2) and 2 wait-list control groups (CTL1 and CTL2) with 42 subjects per group, resulting in an equal number of INT1 and CTL1 of FN background and INT2 and CTL2 of non-FN background.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The inclusion criteria are: (1) age 18 to 30 years, FN background or other ethnicity; (2) Beck Depression Inventory (BDI)-II of at least mild severity (BDI-II score \u226514) and no upper limit; (3) Mini-International Neuropsychiatric Interview (MINI)\u2013confirmed psychiatric diagnosis of major depressive disorder; and (4) fluent in English. All patients are diagnosed by a Centre for Addiction and Mental Health psychiatrist, with diagnoses confirmed using the MINI interview. The exclusion criteria are: (1) individuals receiving weekly structured psychotherapy; (2) individuals who meet the Diagnostic and Statistical Manual of Mental Disorders criteria for severe alcohol\/substance use disorder in the past 3 months, or who demonstrate clinically significant suicidal ideation defined as imminent intent, or who have attempted suicide in the past 6 months; and (3) individuals with comorbid diagnoses of borderline personality, schizophrenia, bipolar disorder, and\/or obsessive compulsive disorder. All subjects are provided standard psychiatric care defined as 1 monthly session that focuses on appropriate medication, with session durations of 15 to 30 min. Experimental subjects receive an additional intervention consisting of the CBT-M online software program (in collaboration with Nex J Health, Inc). Exposure to and interaction with the online workbooks are combined with navigation-coaching delivered by phone and secure text message interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The outcomes selected, combined with measurement blinding, are key features in assessing whether significant benefits regarding depression and anxiety symptoms occur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>If results confirm the hypothesis that youth can be effectively treated with online CBT-M, effective services may be widely delivered with less geographic restriction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>International Registered Report Identifier (IRRID)<\/jats:title>\n                    <jats:p>PRR1-10.2196\/11591<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/11591","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T13:41:28Z","timestamp":1545399688000},"page":"e11591","source":"Crossref","is-referenced-by-count":7,"title":["An Online Mindfulness-Based Cognitive Behavioral Therapy Intervention for Youth Diagnosed With Major Depressive Disorders: Protocol for a Randomized Controlled Trial"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-0083","authenticated-orcid":false,"given":"Paul","family":"Ritvo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9502-0538","authenticated-orcid":false,"given":"Zafiris J","family":"Daskalakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9328-6399","authenticated-orcid":false,"given":"George","family":"Tomlinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1655-2753","authenticated-orcid":false,"given":"Arun","family":"Ravindran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-4914","authenticated-orcid":false,"given":"Renee","family":"Linklater","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2069-2177","authenticated-orcid":false,"given":"Megan","family":"Kirk Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-4505","authenticated-orcid":false,"given":"Yuliya","family":"Knyahnytska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3934-6458","authenticated-orcid":false,"given":"Jonathan","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2784-1283","authenticated-orcid":false,"given":"Nazanin","family":"Alavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-3470","authenticated-orcid":false,"given":"Shari","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-7911","authenticated-orcid":false,"given":"Lillian","family":"Harber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3937-4996","authenticated-orcid":false,"given":"Tania","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-447X","authenticated-orcid":false,"given":"Joel","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2019,7,29]]},"reference":[{"key":"ref1","unstructured":"Public Health Agency of Canada20062019-04-18Ottawa, OntarioGovernment of CanadaThe human face of mental health and mental illness in Canada 2006 http:\/\/www.phac-aspc.gc.ca\/publicat\/human-humain06\/pdf\/human_face_e.pdf"},{"issue":"5","key":"ref2","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1037\/0003-066X.55.5.469","volume":"55","author":"Arnett, JJ","year":"2000","journal-title":"Am Psychol"},{"key":"ref3","author":"Arnett, J","year":"2004","journal-title":"Emerging adulthood: the winding road from the late teens through the twenties"},{"key":"ref4","unstructured":"Canadian Mental Health Association20152019-04-18Mental Health and High School Curriculum Guide http:\/\/www.cmha.ca\/mental_health\/mental-health-and-high-school-curriculum-guide\/#.VVcDuVVViko"},{"key":"ref5","unstructured":"LunauKMacleans Magazine201209052019-04-18The Mental Health Crisis on Campus https:\/\/www.macleans.ca\/education\/uniandcollege\/the-mental-health-crisis-on-campus\/"},{"key":"ref6","unstructured":"The Conference Board of Canada2019-04-18Mental Health Issues in the Labour Force: Reducing the Economic Impact on Canada https:\/\/www.conferenceboard.ca\/e-library\/abstract.aspx?did=4957&AspxAutoDetectCookieSupport=1"},{"issue":"4","key":"ref7","doi-asserted-by":"crossref","first-page":"621","DOI":"10.4088\/JCP.v69n0415","volume":"69","author":"Hofmann, S","year":"2008","journal-title":"J Clin Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/070674371205700202"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4471\/ijep.2013.28"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.17583\/ijep.2016.1504"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2012.08.005"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2011.01.006"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2011.630703"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.75.6.1000"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2011.637242"},{"issue":"2","key":"ref16","first-page":"30","volume":"25","author":"Fashler, S","year":"2015","journal-title":"The Canadian Clinical Psychologist"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2015.06.005"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.3180"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.4871"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X15595178"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.17583\/ijep.2016.1504"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1093\/clipsy\/bph077"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2008.01.005"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1093\/clipsy\/bpg016"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/0163-8343(82)90026-3"},{"key":"ref26","author":"Kabat-Zinn, J","year":"1990","journal-title":"Full Catastrophe Living"},{"key":"ref27","author":"Segal, ZV","year":"2012","journal-title":"Mindfulness-based cognitive therapy for depression"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1089\/acm.2008.0495"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1159\/000365764"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3747\/co.19.1016"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1037\/a0018555"},{"issue":"3","key":"ref32","doi-asserted-by":"crossref","first-page":"272","DOI":"10.4471\/ijep.2013.28","volume":"2","author":"Ritvo, P","year":"2013","journal-title":"Int J Educ Psychol"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2011.616531"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2013.11.003"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.12.020"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2015.12.007"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1177\/0145445517694457"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2014.921834"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2014.07.006"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1177\/0145445515598142"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003440"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.146068"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1853"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.0044"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1602"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1002\/da.20911"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-10-113"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1348\/014466509X472138"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61414-7"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20556"},{"key":"ref51","first-page":"22","volume":"59","author":"Sheehan, DV","year":"1998","journal-title":"J Clin Psychiatry"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.01.010"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1080\/16506070903318960"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2014.01.001"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.3109\/09638237.2011.608747"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20561"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2014.09.008"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1177\/1742395312467658"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1037\/a0035566"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.03.023"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2019\/7\/e11591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:56:36Z","timestamp":1782842196000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.researchprotocols.org\/2019\/7\/e11591\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,29]]},"references-count":60,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2196\/11591","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.11591","asserted-by":"object"}]},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,29]]}}}