Principal Findings
anxiety, mental disorders, depressive, MDD, depression
SAID
This study delivered a 7-module ICBT intervention with general support by nonspecialists to patients with MDD, and compared the findings to those in a WLC group (treatment as usual). The intervention support in most ICBT studies was provided by professional therapists (eg, individual therapist chat sessions [Notably, Shenzhen had a local outbreak of COVID-19, and several residential districts carried out strict lockdown measures during the later stages of our intervention. Some participants in the ICBT group expressed aggravation of depressive and anxiety symptoms owing to the outbreak and enforced isolation, and said that it was difficult to achieve self-regulation using CBT skills (such as behavioral activation and problem solving). Multiple studies reported that the COVID-19 pandemic had caused the deterioration of mental health [Meanwhile, we found that some participants in the ICBT group reported that they felt better, so they did not continue the modules or delayed the intervention until their symptoms worsened. Lundgren et al [General self-efficacy refers to an individual’s self-confidence to deal with difficulties in daily life [The ultimate goal of treatment for MDD is to promote the recovery of patients’ social function and improve their HRQoL [Our intervention was classified as unguided ICBT because we provided general support, but not support related to the therapeutic content. Notably, the adherence of ICBT in this study (31/40, 78%) is similar to the average adherence of guided ICBT (76%) and much better than that of unguided ICBT (54%) [Many patients with mental disorders do not receive adequate treatment because of a lack of trained mental health specialists. It is necessary to apply treatments that are easy to implement in order to address the significant public health burden of depression. Nonspecialist health workers may therefore have an important role in delivering mental health care, and this may be a key strategy for closing the treatment gap [On the other hand, most existing ICBT platforms are presented in the form of web pages (Mood GYM [