Research On Cognitive Behavioral Therapy Based On WeChat Official Account For Patients With Subthreshold Depression

Objectives: Major depressive disorder often brings a higher disease burden.Subthreshold depression is a subclinical stage with certain depressive symptoms and impairment of function,but not meeting the diagnostic criteria for major depressive disorder.Subthreshold depression causes an increase in medical costs and loss of productivity,and has a higher risk of progressing to major depressive disorder.This study aimed to explore the effectiveness of cognitive behavioral therapy based on WeChat official account to improve depressive,anxiety and insomnia symptoms in patients with subthreshold depression,and reduce the incidence of major depressive disorder.This study hopes to provide evidence for the intervention of people at high risk of major depressive disorder.Methods: The patients with subthreshold depression(n = 121)in the psychosomatic outpatient department of Ningbo First Hospital from August,2018 to July,2019 were randomly divided into ICBT group(n = 62)and delayed intervention group(n = 59).The ICBT group provided 6 weeks of cognitive behavioral therapy based on WeChat official account,and delayed intervention group received general mental health education.The two groups used Patient health questionnaire-9,Generalized Anxiety Disorder-7 item scale and Insomnia Severity Index to assess symptoms at baseline,week 6,and week 12.Structured Clinical Interview for DSM-5 was used to determine whether subthreshold depression progressed to major depressive disorder.The Client Satisfaction Questionnaire-8 was used to evaluate the satisfaction of the ICBT group with cognitive behavior therapy based on WeChat official accounts at 6th week.Results: There were no statistically significant differences between the ICBT group and the delayed intervention group at baseline in terms of demographic characteristics and scores on various scales(P <0.05)..The scores of the PHQ-9,GAD-7,and ISI scales in the ICBT group at week 6 and week 12 were lower than the baseline,and the difference was statistically significant(P<0.05).In the delayed intervention group,the scores of PHQ-9 and ISI were lower than baseline at Week 6 and Week 12,and the difference was statistically significant(P<0.05).Comparison between groups showed that the scores of PHQ-9 and GAD-7 in ICBT group were lower than those in delayed intervention group at week 6 and week 12,the difference was statistically significant(P <0.05),and the difference in ISI score was not statistically significant(P> 0.05)).The incidence of major depressive disorder in the ICBT group at week 6 and week 12 was lower than that in the delayed intervention group,but the difference was not statistically significant(P>0.05).91.30%(42/46)of the ICBT users were generally satisfied or very satisfied with the intervention received.Conclusion: Providing cognitive behavioral therapy based on WeChat official account for patients with subthreshold depression helps to improve the symptoms of depression,anxiety and insomnia.This treatment is effective and acceptable to patients,and is a potential clinical intervention.