{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:18Z","timestamp":1785545058661,"version":"3.56.0"},"reference-count":78,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Unguided internet-based cognitive behavioral therapy (ICBT) is a low-cost and scalable treatment for major depressive disorder (MDD), but its long-term effects in Chinese populations remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed (1) to explore the short- and long-term effectiveness of unguided ICBT in treating adults with MDD; (2) to investigate the short- and long-term effects on disease-related symptoms, individual and social functioning, and quality of life; and (3) to assess the acceptability and satisfaction with the ICBT.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An 8-week randomized controlled trial (ChiCTR2100046425) was conducted between August 2021 and June 2023 in Shenzhen, China, with 159 participants in the immediate ICBT group (7-module ICBT course plus usual care) and 158 in the waitlist control (WLC) group (usual care). The WLC group later completed the same ICBT course and follow-up assessments. Outcome measures (depressive and anxiety symptoms, psychological distress, social functioning, self-efficacy, quality of life, and stigma) were assessed before and after treatment and at 3-, 6-, and 12-month follow-ups for ICBT participants. Remission and response, adherence, and satisfaction were evaluated by predefined standards.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 300 participants analyzed (mean age 28.49, SD 7.0 years; female: n=225, 75%), dropout rates were 22.4% (34\/152) in the immediate ICBT group versus 6.3% (10\/158) in the WLC group. At posttreatment, the immediate ICBT group showed greater reduction in depressive symptoms versus WLC (mean difference \u22123.65, SE 0.60;\n P<\/jats:italic>\n <.001;\n d<\/jats:italic>\n =0.50), with higher remission (80\/121, 66.1% vs 58\/148, 39.2%;\n P<\/jats:italic>\n <.001) and response rates (50\/121, 41.3% vs 27\/148, 18.2%;\n P<\/jats:italic>\n <.001). At 12-month follow-up, the depressive symptoms were improved compared with that at pretreatment (mean difference \u22123.90, SE 0.32;\n P<\/jats:italic>\n <.001;\n d<\/jats:italic>\n =0.70), and no significant change was observed in comparison with the outcomes at posttreatment (mean difference \u22120.81, SE 0.33;\n P<\/jats:italic>\n =.33;\n d<\/jats:italic>\n =\u22120.15). ICBT treatment also exhibited similar short- and long-term effects on secondary outcomes, with significant improvement of disease-related symptoms, individual and social functioning, and quality of life. Moreover, the majority of the participants treated with ICBT reported high acceptability of and satisfaction with the ICBT course.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Unguided ICBT effectively reduces depressive symptoms and enhances functioning in Chinese patients with MDD, with sustained benefits over 12 months. Its scalability and low-cost nature make it a promising option for resource-limited settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/68394","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T21:42:12Z","timestamp":1782337332000},"page":"e68394-e68394","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy on Major Depressive Disorder in Chinese Adults: Randomized Controlled Trial With a 12-Month Follow-Up"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3211-1081","authenticated-orcid":false,"given":"Wenjing","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-400X","authenticated-orcid":false,"given":"Huimin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-3200","authenticated-orcid":false,"given":"Yunbin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7436-2440","authenticated-orcid":false,"given":"Yanzhi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-6176","authenticated-orcid":false,"given":"Guangduoji","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8799-8533","authenticated-orcid":false,"given":"Hao","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-9514","authenticated-orcid":false,"given":"Wanxin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5006-6644","authenticated-orcid":false,"given":"Yuhua","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8096-1885","authenticated-orcid":false,"given":"Yifeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2609-5769","authenticated-orcid":false,"given":"Jiejing","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-2523","authenticated-orcid":false,"given":"Roger S","family":"McIntyre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4241-2997","authenticated-orcid":false,"given":"Beifang","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4266-4967","authenticated-orcid":false,"given":"Ciyong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"issue":"10440","key":"R1","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","journal-title":"Lancet"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1038\/s41572-023-00454-1","article-title":"Major depressive disorder","volume":"9","author":"Marx","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/acps.13414","article-title":"Clinical and societal burden of incident major depressive disorder: a population-wide cohort study in Stockholm","volume":"146","author":"Lundberg","journal-title":"Acta Psychiatr Scand"},{"key":"R4","unstructured":"Mental health, brain health and substance use. World Health Organization. 2017. URL: https:\/\/www.who.int\/teams\/mental-health-and-substance-use\/promotion-prevention\/mental-health-in-the-workplace [Accessed 29-03-2023]"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1002\/wps.20701","article-title":"A network meta-analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression","volume":"19","author":"Cuijpers","journal-title":"World Psychiatry"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1192\/bjp.bp.116.188078","article-title":"Undertreatment of people with major depressive disorder in 21 countries","volume":"210","author":"Thornicroft","journal-title":"Br J Psychiatry"},{"issue":"9","key":"R7","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1017\/S0033291717003336","article-title":"Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys","volume":"48","author":"Evans-Lacko","journal-title":"Psychol Med"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-024-05965-z","article-title":"Examining the mental health services among people with mental disorders: a literature review","volume":"24","author":"Gao","journal-title":"BMC Psychiatry"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1002\/wps.20610","article-title":"Internet-delivered psychological treatments: from innovation to implementation","volume":"18","author":"Andersson","journal-title":"World Psychiatry"},{"issue":"12","key":"R10","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-24-02180","article-title":"Nonpharmacologic and pharmacologic treatments of adults in the acute phase of major depressive disorder: a living clinical guideline from the American College of Physicians","volume":"177","author":"Etxeandia-Ikobaltzeta","journal-title":"Ann Intern Med"},{"key":"R11","unstructured":"Depression in Adults: Treatment and Management. National Institute for Health and Care Excellence (NICE); 2022. [Medline: 35977056]"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.04.104","article-title":"Guidelines for the diagnosis and treatment of depressive disorders in China: the second edition","volume":"253","author":"Feng","journal-title":"J Affect Disord"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2019-100053","article-title":"Development and challenges of mental health in China","volume":"32","author":"Que","journal-title":"Gen Psychiatry"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100992","article-title":"Professional characteristics, numbers, distribution and training of China\u2019s mental health workforce from 2000 to 2020: a scoping review","volume":"45","author":"Sun","journal-title":"Lancet Reg Health West Pac"},{"issue":"11","key":"R15","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1016\/S2215-0366(21)00251-0","article-title":"Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study","volume":"8","author":"Lu","journal-title":"Lancet Psychiatry"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1001\/jamapsychiatry.2017.0044","article-title":"Efficacy of self-guided internet-based cognitive behavioral therapy in the treatment of depressive symptoms: a meta-analysis of individual participant data","volume":"74","author":"Karyotaki","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-04325-z","article-title":"Efficacy of computer- and\/or internet-based cognitive-behavioral guided self-management for depression in adults: a systematic review and meta-analysis of randomized controlled trials","volume":"22","author":"Mamukashvili-Delau","journal-title":"BMC Psychiatry"},{"issue":"6","key":"R18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010939","article-title":"Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance","volume":"5","author":"Titov","journal-title":"PLoS One"},{"issue":"4","key":"R19","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1080\/16506073.2011.616531","article-title":"Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help","volume":"40","author":"Berger","journal-title":"Cogn Behav Ther"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jad.2011.11.003","article-title":"Culturally attuned Internet treatment for depression amongst Chinese Australians: a randomised controlled trial","volume":"136","author":"Choi","journal-title":"J Affect Disord"},{"issue":"8","key":"R21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070086","article-title":"A randomized controlled trial evaluating a manualized TeleCoaching protocol for improving adherence to a web-based intervention for the treatment of depression","volume":"8","author":"Mohr","journal-title":"PLoS One"},{"issue":"12","key":"R22","doi-asserted-by":"publisher","first-page":"2635","DOI":"10.1017\/S0033291713000111","article-title":"Internet cognitive behavioural therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care","volume":"43","author":"Newby","journal-title":"Psychol Med"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5627","article-title":"Computerised cognitive behaviour therapy (cCBT) as treatment for depression in primary care (REEACT trial): large scale pragmatic randomised controlled trial","volume":"351","author":"Gilbody","journal-title":"BMJ"},{"issue":"8","key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5695","article-title":"An internet-based intervention for depression in primary care in Spain: a randomized controlled trial","volume":"18","author":"Montero-Mar\u00edn","journal-title":"J Med Internet Res"},{"issue":"11","key":"R25","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8602","article-title":"Smartphone cognitive behavioral therapy as an adjunct to pharmacotherapy for refractory depression: randomized controlled trial","volume":"19","author":"Mantani","journal-title":"J Med Internet Res"},{"issue":"5","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7274","article-title":"Web-based cognitive behavior therapy for depression in people with diabetes mellitus: a randomized controlled trial","volume":"19","author":"Newby","journal-title":"J Med Internet Res"},{"issue":"3","key":"R27","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1002\/da.22590","article-title":"Internet-based cognitive behavior therapy for major depressive disorder: a randomized controlled trial","volume":"34","author":"Rosso","journal-title":"Depress Anxiety"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2017.05.001","article-title":"Help from home for depression: a randomised controlled trial comparing internet-delivered cognitive behaviour therapy with bibliotherapy for depression","volume":"9","author":"Smith","journal-title":"Internet Interv"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1037\/ser0000261","article-title":"Behavioral and cognitive intervention strategies delivered via coached apps for depression: pilot trial","volume":"16","author":"Stiles-Shields","journal-title":"Psychol Serv"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.2196\/41005","article-title":"An unguided, computerized cognitive behavioral therapy intervention (TreadWill) in a lower middle-income country: pragmatic randomized controlled trial","volume":"25","author":"Ghosh","journal-title":"J Med Internet Res"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2017.11.007","article-title":"Outcomes of an online computerized cognitive behavioral treatment program for treating Chinese patients with depression: a pilot study","volume":"38","author":"Yeung","journal-title":"Asian J Psychiatr"},{"issue":"10","key":"R32","doi-asserted-by":"publisher","DOI":"10.2196\/21336","article-title":"Twelve-month follow-up to a fully automated internet-based cognitive behavior therapy intervention for rural adults with depression symptoms: single-arm longitudinal study","volume":"22","author":"Schure","journal-title":"J Med Internet Res"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2024.102518","article-title":"Do the effects of internet-delivered cognitive-behavioral therapy (i-CBT) last after a year and beyond? A meta-analysis of 154 randomized controlled trials (RCTs)","volume":"114","author":"Zainal","journal-title":"Clin Psychol Rev"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1001\/jamapsychiatry.2020.4364","article-title":"Internet-based cognitive behavioral therapy for depression: a systematic review and individual patient data network meta-analysis","volume":"78","author":"Karyotaki","journal-title":"JAMA Psychiatry"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/46925","article-title":"Long-term efficacy of internet-based cognitive behavioral therapy self-help programs for adults with depression: systematic review and meta-analysis of randomized controlled trials","volume":"10","author":"Mamukashvili-Delau","journal-title":"JMIR Ment Health"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1037\/ccp0000171","article-title":"Effectiveness of an internet intervention (Deprexis) for depression in a United States adult sample: a parallel-group pragmatic randomized controlled trial","volume":"85","author":"Beevers","journal-title":"J Consult Clin Psychol"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.2196\/42786","article-title":"The effect of internet-based cognitive behavioral therapy on major depressive disorder: randomized controlled trial","volume":"25","author":"Lin","journal-title":"J Med Internet Res"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.2196\/50780","article-title":"Race, ethnicity, and other cultural background factors in trials of internet-based cognitive behavioral therapy for depression: systematic review","volume":"26","author":"De Jes\u00fas-Romero","journal-title":"J Med Internet Res"},{"issue":"5","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/26883","article-title":"The efficacy of computerized cognitive behavioral therapy for depressive and anxiety symptoms in patients with COVID-19: randomized controlled trial","volume":"23","author":"Liu","journal-title":"J Med Internet Res"},{"issue":"7","key":"R40","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1002\/jclp.23329","article-title":"The efficacy and optimal matching of an Internet-based acceptance and commitment therapy intervention for depressive symptoms among university students: a randomized controlled trial in China","volume":"78","author":"Zhao","journal-title":"J Clin Psychol"},{"issue":"9","key":"R41","doi-asserted-by":"publisher","first-page":"3932","DOI":"10.1017\/S0033291722000599","article-title":"Efficacy of an internet-based cognitive behavioral therapy for subthreshold depression among Chinese adults: a randomized controlled trial","volume":"53","author":"Ying","journal-title":"Psychol Med"},{"key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/40187","article-title":"Efficacy of internet-based cognitive behavioral therapy for subthreshold depression among older adults in institutional long-term care settings: pragmatic randomized controlled trial","volume":"26","author":"Kong","journal-title":"J Med Internet Res"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.2196\/64303","article-title":"Culturally adapted guided internet-based cognitive behavioral therapy for Hong Kong people with depressive symptoms: randomized controlled trial","volume":"27","author":"Pan","journal-title":"J Med Internet Res"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.915689","article-title":"Remission of symptoms is not equal to functional recovery: Psychosocial functioning impairment in major depression","volume":"13","author":"Yang","journal-title":"Front Psychiatry"},{"issue":"4","key":"R45","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1923","article-title":"CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions","volume":"13","author":"Eysenbach","journal-title":"J Med Internet Res"},{"key":"R46","volume":"59 Suppl 20","author":"Sheehan","journal-title":"J Clin Psychiatry"},{"key":"R47","doi-asserted-by":"crossref","unstructured":"Guze SB . Diagnostic and Statistical Manual of Mental Disorders. Vol 152. 4th ed. AJP American Psychiatric Publishing; 1995:1228-1228. [doi: 10.1176\/ajp.152.8.1228]","DOI":"10.1176\/ajp.152.8.1228"},{"issue":"4","key":"R48","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1111\/j.1468-2850.2006.00043.x","article-title":"A heuristic framework for the cultural adaptation of interventions","volume":"13","author":"Barrera","journal-title":"Clin Psychol Sci Pract"},{"issue":"18","key":"R49","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","article-title":"Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire","volume":"282","author":"Spitzer","journal-title":"JAMA"},{"key":"R50","unstructured":"Clark PD Oates M . Measuring improvement and recovery adult services version 2. Improving Access to Psychological Therapies. 2014. URL: https:\/\/www.healthinnovationoxford.org\/wp-content\/uploads\/2015\/11\/measuring-recovery-2014.pdf [Accessed 20-05-2026]"},{"issue":"85","key":"R51","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-0293-8","article-title":"A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety","volume":"3","author":"Richards","journal-title":"NPJ Digit Med"},{"issue":"10","key":"R52","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","journal-title":"Arch Intern Med"},{"issue":"6","key":"R53","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1017\/s0033291702006074","article-title":"Short screening scales to monitor population prevalences and trends in non-specific psychological distress","volume":"32","author":"Kessler","journal-title":"Psychol Med"},{"key":"R54","doi-asserted-by":"publisher","DOI":"10.1097\/00004850-199606003-00015","article-title":"The measurement of disability","volume":"11 Suppl 3","author":"Sheehan","journal-title":"Int Clin Psychopharmacol"},{"issue":"2","key":"R55","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/S0167-6296(01)00130-8","article-title":"The estimation of a preference-based measure of health from the SF-36","volume":"21","author":"Brazier","journal-title":"J Health Econ"},{"key":"R56","volume":"3","author":"Schwarzer","journal-title":"World Psychol"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-8-25","article-title":"Predictors of depression stigma","volume":"8","author":"Griffiths","journal-title":"BMC Psychiatry"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.11.003","article-title":"Modified intention-to-treat analysis did not bias trial results","volume":"72","author":"Dossing","journal-title":"J Clin Epidemiol"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2445","article-title":"Deviation from intention to treat analysis in randomised trials and treatment effect estimates: meta-epidemiological study","volume":"350","author":"Abraha","journal-title":"BMJ"},{"issue":"10","key":"R60","doi-asserted-by":"publisher","first-page":"e668","DOI":"10.1016\/S2589-7500(23)00109-7","article-title":"Internet-delivered cognitive behavioural therapy programme to reduce depressive symptoms in patients with multiple sclerosis: a multicentre, randomised, controlled, phase 3 trial","volume":"5","author":"Gold","journal-title":"Lancet Digit Health"},{"key":"R61","unstructured":"International Conference on Harmonisation. E9: statistical principles for clinical trials. US Food & Drug Administration. 1998. URL: https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/e9-statistical-principles-clinical-trials [Accessed 17-11-2025]"},{"issue":"3","key":"R62","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1177\/17407745231160074","article-title":"Using modified intention-to-treat as a principal stratum estimator for failure to initiate treatment","volume":"20","author":"Kahan","journal-title":"Clin Trials"},{"issue":"1","key":"R63","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/mpr.329","article-title":"Multiple imputation by chained equations: what is it and how does it work?","volume":"20","author":"Azur","journal-title":"Int J Methods Psychiatr Res"},{"issue":"1","key":"R64","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1080\/07350015.1986.10509497","article-title":"Statistical matching using file concatenation with adjusted weights and multiple imputations","volume":"4","author":"Rubin","journal-title":"J Bus Econ Stat"},{"issue":"1","key":"R65","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1037\/a0014699","article-title":"Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis","volume":"14","author":"Feingold","journal-title":"Psychol Methods"},{"issue":"1","key":"R66","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1037\/1082-989x.7.1.105","article-title":"Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs","volume":"7","author":"Morris","journal-title":"Psychol Methods"},{"issue":"1","key":"R67","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1037\/\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","journal-title":"Psychol Bull"},{"issue":"3","key":"R68","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S2215-0366(24)00404-8","article-title":"Efficacy and effectiveness of therapist-guided internet versus face-to-face cognitive behavioural therapy for depression via counterfactual inference using naturalistic registers and machine learning in Finland: a retrospective cohort study","volume":"12","author":"Rosenstr\u00f6m","journal-title":"Lancet Psychiatry"},{"key":"R69","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2017.10.003","article-title":"The effectiveness of unguided internet cognitive behavioural therapy for mixed anxiety and depression","volume":"10","author":"Morgan","journal-title":"Internet Interv"},{"key":"R70","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2020.100310","article-title":"Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: a randomised controlled trial","volume":"20","author":"Kladnitski","journal-title":"Internet Interv"},{"key":"R71","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2017.07.003","article-title":"Preventing depression: qualitatively examining the benefits of depression-focused iCBT for participants who do not meet clinical thresholds","volume":"9","author":"Earley","journal-title":"Internet Interv"},{"issue":"1","key":"R72","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-021-03297-w","article-title":"Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study","volume":"21","author":"Lindegaard","journal-title":"BMC Psychiatry"},{"key":"R73","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2023.100654","article-title":"The effect of internet-delivered cognitive behavioral therapy for depression and anxiety on quality of life: a meta-analysis of randomized controlled trials","volume":"33","author":"Maj","journal-title":"Internet Interv"},{"issue":"3","key":"R74","doi-asserted-by":"publisher","first-page":"341","DOI":"10.4088\/JCP.10m06176blu","article-title":"Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA)","volume":"72","author":"Lamers","journal-title":"J Clin Psychiatry"},{"issue":"3","key":"R75","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1017\/S2045796015000189","article-title":"Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys","volume":"24","author":"Kessler","journal-title":"Epidemiol Psychiatr Sci"},{"key":"R76","doi-asserted-by":"publisher","DOI":"10.2196\/67567","article-title":"Cost utility analysis of internet-based cognitive behavioral therapy for major depressive disorder: randomized controlled trial","volume":"27","author":"Zhou","journal-title":"J Med Internet Res"},{"key":"R77","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2025.101515","article-title":"Evolving role of the internet in China as a medium for promoting psychological well-being and mental health: a scoping review","volume":"56","author":"Zhu","journal-title":"Lancet Reg Health West Pac"},{"key":"R78","doi-asserted-by":"publisher","DOI":"10.2196\/41815","article-title":"Trajectories of symptoms in digital interventions for depression and anxiety using routine outcome monitoring data: secondary analysis study","volume":"11","author":"Cumpanasoiu","journal-title":"JMIR Mhealth Uhealth"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e68394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:27:15Z","timestamp":1785536835000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e68394"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":78,"URL":"https:\/\/doi.org\/10.2196\/68394","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"article-number":"v14i10440e68394"}}