{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:45:46Z","timestamp":1785545146739,"version":"3.56.0"},"reference-count":51,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive behavioral therapy (CBT), implemented it in healthy children, and reported its effectiveness for health promotion.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The participants were 115 children with mental health disorders (eg, school refusal, orthostatic hypotension, eating disorders, developmental disorders, among others) and aged 12\u201018 years. The CBT app\u2013based program comprised 1 week of psychoeducation followed by 1 week of self-monitoring. After reading story-like scenarios, participants created a self-monitoring sheet with 5 panels: events, thoughts, feelings, body responses, and actions. All participants received regular mental health care from physicians in addition to the app-based program. To evaluate the participants\u2019 depressive symptoms and QOL, Patient Health Questionnaire for Adolescents (PHQ-9A), Depression Self-Rating Scale for Children (DSRS-C), and Pediatric Quality of Life Inventory (PedsQL) were measured at the beginning of the intervention, and at 2 and 6 months thereafter. Questionnaire for Triage and Assessment with 30 items (QTA30), and Rosenberg Self-Esteem Scale (RSES) were also used to measure their health and self-esteem. Participants were divided into 4 groups on the basis of the PHQ-9A score (above or below the cutoff; PHQ-9A\u22655 or PHQ-9A<5) and completion or noncompletion of the CBT app\u2013based program (app [+] or app [-]). The primary outcome was improvement in the DSRS-C score, and secondary outcomes were improvement in other psychometric scales including PedsQL, QTA30, and RSE. A paired-samples\n t<\/jats:italic>\n test was used for statistical analysis. The Medical Ethics Committee of Fukuoka University Faculty of Medicine (approval U22-05-002) approved the study design.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 48, 18, 18, and 7 participants in the PHQ-9A\u22655 app (+), PHQ-9A\u22655 app (-), PHQ-9A<5 app (+), and PHQ-9A<5 app (-) groups, respectively. A total of 24 participants dropped out. No improvement in the DSRS-C score was observed in all groups. However, PedsQL scores improved significantly at 2 and 6 months in the PHQ-9A<5 app (+) group (\n t<\/jats:italic>\n 17<\/jats:sub>\n =6.62;\n P<\/jats:italic>\n <.001 and\n t<\/jats:italic>\n 17<\/jats:sub>\n =6.11;\n P<\/jats:italic>\n <.001, respectively). There was a significant positive correlation between the PHQ-9A scores and the number of self-monitoring sheets completed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The CBT app was useful for improving PedsQL scores of children with mental health disorders. However, a higher-intensity CBT program is necessary for more severely depressed children.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/60943","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T14:20:08Z","timestamp":1747059608000},"page":"e60943-e60943","source":"Crossref","is-referenced-by-count":0,"title":["Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical 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