%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 23
%N 5
%P e26883
%T The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial
%A Liu,Zhifen
%A Qiao,Dan
%A Xu,Yifan
%A Zhao,Wentao
%A Yang,Yang
%A Wen,Dan
%A Li,Xinrong
%A Nie,Xiaoping
%A Dong,Yongkang
%A Tang,Shiyou
%A Jiang,Yi
%A Wang,Ying
%A Zhao,Juan
%A Xu,Yong
%+ Department of Psychiatry, The First Hospital of Shanxi Medical University, 85 Jiefang South Street, Yingze District, Taiyuan, 030001, China, 86 351 4639641, xuyongsmu@vip.163.com
%K mental health
%K depression
%K anxiety
%K COVID-19
%K treatment
%K cCBT
%K computerized cognitive behavioral therapy
%D 2021
%7 14.5.2021
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: The prevalence of depressive and anxiety symptoms in patients with COVID-19 is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was needed. Cognitive behavioral therapy (CBT) is the first-line psychological therapy in clinical treatment. Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response. Objective: This study aims to evaluate the efficacy of the cCBT program we developed in improving depressive and anxiety symptoms among patients with COVID-19. Methods: We customized a cCBT program focused on improving depressive and anxiety symptoms among patients with COVID-19, and then, we assessed its effectiveness. Screening was based on symptoms of depression or anxiety for patients who scored ≥7 on the Hamilton Depression Rating Scale (HAMD17) or the Hamilton Anxiety Scale (HAMA). A total of 252 patients with COVID-19 at five sites were randomized into two groups: cCBT + treatment as usual (TAU; n=126) and TAU without cCBT (n=126). The cCBT + TAU group received the cCBT intervention program for 1 week. The primary efficacy measures were the HAMD17 and HAMA scores. The secondary outcome measures were the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Athens Insomnia Scale (AIS). Assessments were carried out pre- and postintervention. The patients’ symptoms of anxiety and depression in one of the centers were assessed again within 1 month after the postintervention assessment. Results: The cCBT + TAU group displayed a significantly decreased score on the HAMD17, HAMA, SDS, SAS, and AIS after the intervention compared to the TAU group (all P<.001). A mixed-effects repeated measures model revealed significant improvement in symptoms of depression (HAMD17 and SDS scores, both P<.001), anxiety (HAMA and SAS scores, both P<.001), and insomnia (AIS score, P=.002) during the postintervention and follow-up periods in the cCBT + TAU group. Additionally, the improvement of insomnia among females (P=.14) and those with middle school education (P=.48) in the cCBT + TAU group showed no significant differences when compared to the TAU group. Conclusions: The findings of this study suggest that the cCBT program we developed was an effective nonpharmacological treatment for symptoms of anxiety, depression, and insomnia among patients with COVID-19. Further research is warranted to investigate the long-term effects of cCBT for symptoms of anxiety, depression, and insomnia in patients with COVID-19. Trial Registration: Chinese Clinical Trial Registry ChiCTR2000030084; http://www.chictr.org.cn/showprojen.aspx?proj=49952 
%M 33900931
%R 10.2196/26883
%U https://www.jmir.org/2021/5/e26883
%U https://doi.org/10.2196/26883
%U http://www.ncbi.nlm.nih.gov/pubmed/33900931