New Study by the Assistant Professorship of Psychology and Digital Mental Health Care shows: Internet-Based Prevention Programs Can Reduce the Risk of Depression

Digital programs could play an important role in the prevention of mental disorders in the future. A recent study by a research group led by Prof. Dr. David Daniel Ebert shows that an internet-based prevention program can significantly reduce the risk of developing a depressive disorder or an anxiety disorder. The results of the study “Internet-based indicated prevention of anxiety and depression disorder onset three-arm randomized clinical trial” were published in the journal npj Digital Medicine of the Nature Publishing Group. The journal has an impact factor of 15.1.

At the center of the investigation is a so-called transdiagnostic intervention concept. Unlike many traditional programs, it does not focus solely on individual problem areas, but simultaneously addresses depressive and anxiety-related difficulties. The reason is that both disorders share numerous common risk factors, including traumatic life experiences, emotional neglect, a pronounced tendency to worry, or low self-efficacy.

“The study shows how great the potential of digital prevention can be. It can reach people at an early stage, before mental disorders fully develop, and help effectively prevent the onset of depression and anxiety disorders,” explains Prof. Ebert, Head of the Assistant Professorship of Psychology and Digital Mental Health Care.

Digital training over several weeks

A total of 566 adults with elevated but not yet clinically diagnosed depressive or anxiety-related symptoms participated in the randomized controlled trial. The aim was to prevent the transition from early warning signs to a manifest mental disorder. “We ourselves were surprised by how large the preventive effects turned out to be: a 41 percent reduction in depressive symptoms and 53 percent in anxiety disorders,” says Prof. Ebert.

Participants completed a structured online program over several weeks. This included eight digital sessions with videos, psychoeducational content, and concrete reflection tasks. Among other things, strategies from cognitive behavioral therapy were taught, for example for dealing with distressing thoughts, worries, or mood fluctuations.

However, the focus was not solely on the weekly lessons. What was particularly decisive was implementation in everyday life. Participants were guided to systematically test new behaviors, reflect on their experiences, and develop individual training plans from them. The program could also be personalized over time so that content was increasingly adapted to individual needs.

Individual and automated support

A particular focus of the study was the question of which form of support is necessary for digital prevention programs. For this purpose, three groups were compared: one group received individual feedback from psychologists, a second group received exclusively automated feedback from an algorithm, while a third control group received no additional intervention.

The personal feedback mainly consisted of commenting on completed tasks and accompanying participants throughout the learning process. The automated version, by contrast, generated standardized, positively worded, and validating texts. “What was remarkable was that individual and automated feedback were almost equally effective. This suddenly makes prevention much more scalable,” explains Prof. Ebert.

Starting earlier instead of only treating

The results address a fundamental challenge in mental health care systems. Many care systems are primarily treatment-oriented—that is, they support people only once a disorder is already present. At the same time, it often takes a long time before affected individuals seek help at all.

Digital prevention programs could close an important gap here. They are easily accessible and can already be used in early stages when first symptoms appear. “The severity of symptoms is less decisive. What matters much more is whether people are willing to learn something and actively participate,” says Ebert.

Such programs are aimed particularly at people who are motivated to learn strategies to improve their well-being in the long term and make dealing with worries and anxieties easier. However, they are not designed for people with severe psychotic disorders such as schizophrenia. In cases of pronounced suicidal thoughts, digital prevention should always be combined with additional professional support.

Potential for broader application

Digital services for the treatment of depression already exist today. Prevention programs specifically designed to intervene before the onset of a disorder are comparatively rare. The study results show that internet-based interventions could represent an effective and efficient way to prevent—or at least significantly delay—the transition from subclinical symptoms to a diagnosed depression or anxiety disorder.

In the long term, such programs could become an important complement to conventional care—especially in order to reach people early and provide preventive support.

To the homepage of the Assistant Professorship of Psychology and Digital Mental Health Care
To the study: “Internet-based indicated prevention of anxiety and depression disorder onset three-arm randomized clinical trial”

Contact:

Prof. Dr. David Daniel Ebert
Assistant Professorship of Psychology and Digital Mental Health Care
Am Olympiacampus 11
80809 Munich

E-Mail: david.daniel.ebert@tum.de

Text: Bastian Daneyko
Photos: npj Digital Medicine/Private