The efficacy of a culturally adapted iCBT program on depression among Chinese emerging adults: A randomized...

Depression is a prevalent mental health problem among young adults, with wide-ranging negative consequences. Digital psychological interventions can help address the mental health service gap; however, culturally adapted programs remain scarce. This study evaluated the efficacy of an internet-based cognitive behavioral therapy (iCBT) program, adapted to the Chinese university context, in alleviating depression and anxiety among college students.

A three-arm randomized controlled trial was conducted with 504 university students with mild to moderate depression, who were randomly assigned to an intervention group, an active control group, or a waitlist control group. Depression and anxiety symptoms were assessed using the Beck Depression Inventory-II (BDI-II) and the Generalized Anxiety Disorder-7 (GAD-7).

Compared with the waitlist control, the intervention group demonstrated greater reductions in depression (Cohen's d = 0.42) and anxiety (Cohen's d = 0.34) at post-treatment. These effects were maintained at the one-month follow-up (Cohen's d = 0.60). At follow-up, the active control group also showed greater improvements than the waitlist control (depression, Cohen's d = 0.48; anxiety, Cohen's d = 0.55). Positive attitudes toward iCBT were associated with better outcomes, indicating a moderating effect.

The culturally adapted iCBT program demonstrated significant efficacy in reducing depression and anxiety among Chinese university students and offered a cost-effective alternative to local mental health resources. Alongside the active control condition, both approaches showed promising potential to support students in coping with depression.Trial Registration: ChiCTR2500104856.