INTRODUCTION Limited research exists on intervention efficacy for comorbid subclinical anxiety and depressive disorders, despite their common co-occurrence. Internet- and mobile-based interventions (IMIs) are promising to reach individuals facing subclinical symptoms. OBJECTIVE This study aimed to evaluate the efficacy of a transdiagnostic and self-tailored IMI in reducing subclinical anxiety and depressive symptom severity with either individualized (IG-IMI) or automated (AG-IMI) guidance compared to a waitlist control group with care-as-usual access (WLC). METHODS Participants included 566 adults with subclinical anxiety (GAD-7 ≥ 5) and/or depressive (CES-D ≥16) symptoms, who did not meet criteria for a full-syndrome depressive or anxiety disorder. In a three-arm randomized clinical trial, participants were randomized to a cognitive behavioral 7-session IMI plus booster session with IG-IMI (n = 186) or AG-IMI (n = 189) or WLC (n = 191). Primary outcomes included observer-rated anxiety (HAM-A) and depressive (QIDS) symptom severity 8 weeks after randomization assessed by blinded raters via telephone. Follow-up outcomes at 6 and 12 months are reported. RESULTS Symptom severity was significantly lower with small to medium effects in IG-IMI (anxiety: d = 0.45, depression: d = 0.43) and AG-IMI (anxiety: d = 0.31, depression: d = 0.32) compared to WLC. No significant differences emerged between guidance formats in primary outcomes. There was a significant effect in HAM-A after 6 months favoring AG-IMI. On average, participants completed 85.38% of IG-IMI and 77.38% of AG-IMI. CONCLUSIONS A transdiagnostic, self-tailored IMI can reduce subclinical anxiety and depressive symptom severity, but 12-month long-term effects were absent. Automated guidance holds promise for enhancing the scalability of IMIs in broad prevention initiatives.

中文翻译：

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两种指导形式的基于互联网和移动设备的亚临床焦虑和抑郁干预措施（ICare Prevent）的功效：三组随机对照试验的结果。


引言 尽管亚临床焦虑症和抑郁症常见同时发生，但对它们的干预效果的研究还很有限。基于互联网和移动设备的干预措施（IMIs）有望惠及面临亚临床症状的个体。目的 本研究旨在评估跨诊断和自我定制的 IMI 在减少亚临床焦虑和抑郁症状严重程度方面的功效，无论是个体化 (IG-IMI) 或自动化 (AG-IMI) 指导，与等待名单对照组（护理组）相比。 - 普通访问 (WLC)。方法 参与者包括 566 名患有亚临床焦虑 (GAD-7 ≥ 5) 和/或抑郁 (CES-D ≥ 16) 症状的成年人，他们不符合全综合征抑郁或焦虑障碍的标准。在一项三组随机临床试验中，参与者被随机分配接受 7 次 IMI 认知行为加加强疗程 IG-IMI (n = 186) 或 AG-IMI (n = 189) 或 WLC (n = 191)。主要结局包括随机分组后 8 周观察者评定的焦虑 (HAM-A) 和抑郁 (QIDS) 症状严重程度，由盲法评估者通过电话进行评估。报告 6 个月和 12 个月的随访结果。结果 与 WLC 相比，IG-IMI（焦虑：d = 0.45，抑郁：d = 0.43）和 AG-IMI（焦虑：d = 0.31，抑郁：d = 0.32）的症状严重程度显着降低，且影响较小至中等。指导格式之间的主要结果没有出现显着差异。 6 个月后，HAM-A 出现显着效果，有利于 AG-IMI。平均而言，参与者完成了 IG-IMI 的 85.38% 和 AG-IMI 的 77.38%。结论 跨诊断、自我定制的 IMI 可以减轻亚临床焦虑和抑郁症状的严重程度，但不存在 12 个月的长期效果。 自动化指导有望增强 IMI 在广泛预防计划中的可扩展性。