Effects of an internet-based cognitive behavioral therapy (iCBT) program in manga format on improving subthreshold depressive symptoms among healthy workers: A randomized controlled trial

Kotaro Imamura, Norito Kawakami, Toshi A. Furukawa, Yutaka Matsuyama, Akihito Shimazu, Rino Umanodan, Sonoko Kawakami, Kiyoto Kasai

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective: The purpose of this study was to develop a new Internet-based computerized cognitive behavior therapy (iCBT) program in Manga format, the Japanese cartoon, for workers and to examine the effects of the iCBT program on improving subthreshold depression using a randomized controlled trial (RCT) design among workers employed in private companies in Japan. Method: All workers in a company (n = 290) and all workers in three departments (n = 1,500) at the headquarters of another large company were recruited by an invitation e-mail. Participants who fulfilled the inclusion criteria were randomly allocated to intervention or control groups (N = 381 for each group). A six-week, six-lesson iCBT program using Manga (Japanese comic) story was developed. The program included several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem solving, and relaxation. The intervention group studied the iCBT program at a frequency of one lesson per week. Depression (Beck Depression Inventory II; BDI-II) was assessed as a primary outcome at baseline, and threeand six-month follow-ups for both intervention and control groups were performed. Results: The iCBT program showed a significant intervention effect on BDI-II (t = -1.99, p<0.05) with small effect sizes (Cohen's d: -0.16, 95% Confidence Interval: -0.32 to 0.00, at six-month follow-up). Conclusions: The present study first demonstrated that a computerized cognitive behavior therapy delivered via the Internet was effective in improving depression in the general working population. It seems critical to improve program involvement of participants in order to enhance the effect size of an iCBT program. Trial Registration: UMIN Clinical Trials Registry UMIN000006210.

Original languageEnglish
Article numbere97167
JournalPloS one
Volume9
Issue number5
DOIs
Publication statusPublished - 2014 May 20
Externally publishedYes

Fingerprint

Cognitive Therapy
Internet
Randomized Controlled Trials
Depression
therapeutics
behavior modification
assertiveness
Cartoons
Assertiveness
Industry
e-mail
Control Groups
labor force
Postal Service
Registries
confidence interval
clinical trials
Japan
Clinical Trials
Confidence Intervals

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Effects of an internet-based cognitive behavioral therapy (iCBT) program in manga format on improving subthreshold depressive symptoms among healthy workers : A randomized controlled trial. / Imamura, Kotaro; Kawakami, Norito; Furukawa, Toshi A.; Matsuyama, Yutaka; Shimazu, Akihito; Umanodan, Rino; Kawakami, Sonoko; Kasai, Kiyoto.

In: PloS one, Vol. 9, No. 5, e97167, 20.05.2014.

Research output: Contribution to journalArticle

Imamura, Kotaro ; Kawakami, Norito ; Furukawa, Toshi A. ; Matsuyama, Yutaka ; Shimazu, Akihito ; Umanodan, Rino ; Kawakami, Sonoko ; Kasai, Kiyoto. / Effects of an internet-based cognitive behavioral therapy (iCBT) program in manga format on improving subthreshold depressive symptoms among healthy workers : A randomized controlled trial. In: PloS one. 2014 ; Vol. 9, No. 5.
@article{bb5f0f5cd17246129f817dc29ae290a4,
title = "Effects of an internet-based cognitive behavioral therapy (iCBT) program in manga format on improving subthreshold depressive symptoms among healthy workers: A randomized controlled trial",
abstract = "Objective: The purpose of this study was to develop a new Internet-based computerized cognitive behavior therapy (iCBT) program in Manga format, the Japanese cartoon, for workers and to examine the effects of the iCBT program on improving subthreshold depression using a randomized controlled trial (RCT) design among workers employed in private companies in Japan. Method: All workers in a company (n = 290) and all workers in three departments (n = 1,500) at the headquarters of another large company were recruited by an invitation e-mail. Participants who fulfilled the inclusion criteria were randomly allocated to intervention or control groups (N = 381 for each group). A six-week, six-lesson iCBT program using Manga (Japanese comic) story was developed. The program included several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem solving, and relaxation. The intervention group studied the iCBT program at a frequency of one lesson per week. Depression (Beck Depression Inventory II; BDI-II) was assessed as a primary outcome at baseline, and threeand six-month follow-ups for both intervention and control groups were performed. Results: The iCBT program showed a significant intervention effect on BDI-II (t = -1.99, p<0.05) with small effect sizes (Cohen's d: -0.16, 95{\%} Confidence Interval: -0.32 to 0.00, at six-month follow-up). Conclusions: The present study first demonstrated that a computerized cognitive behavior therapy delivered via the Internet was effective in improving depression in the general working population. It seems critical to improve program involvement of participants in order to enhance the effect size of an iCBT program. Trial Registration: UMIN Clinical Trials Registry UMIN000006210.",
author = "Kotaro Imamura and Norito Kawakami and Furukawa, {Toshi A.} and Yutaka Matsuyama and Akihito Shimazu and Rino Umanodan and Sonoko Kawakami and Kiyoto Kasai",
year = "2014",
month = "5",
day = "20",
doi = "10.1371/journal.pone.0097167",
language = "English",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

TY - JOUR

T1 - Effects of an internet-based cognitive behavioral therapy (iCBT) program in manga format on improving subthreshold depressive symptoms among healthy workers

T2 - A randomized controlled trial

AU - Imamura, Kotaro

AU - Kawakami, Norito

AU - Furukawa, Toshi A.

AU - Matsuyama, Yutaka

AU - Shimazu, Akihito

AU - Umanodan, Rino

AU - Kawakami, Sonoko

AU - Kasai, Kiyoto

PY - 2014/5/20

Y1 - 2014/5/20

N2 - Objective: The purpose of this study was to develop a new Internet-based computerized cognitive behavior therapy (iCBT) program in Manga format, the Japanese cartoon, for workers and to examine the effects of the iCBT program on improving subthreshold depression using a randomized controlled trial (RCT) design among workers employed in private companies in Japan. Method: All workers in a company (n = 290) and all workers in three departments (n = 1,500) at the headquarters of another large company were recruited by an invitation e-mail. Participants who fulfilled the inclusion criteria were randomly allocated to intervention or control groups (N = 381 for each group). A six-week, six-lesson iCBT program using Manga (Japanese comic) story was developed. The program included several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem solving, and relaxation. The intervention group studied the iCBT program at a frequency of one lesson per week. Depression (Beck Depression Inventory II; BDI-II) was assessed as a primary outcome at baseline, and threeand six-month follow-ups for both intervention and control groups were performed. Results: The iCBT program showed a significant intervention effect on BDI-II (t = -1.99, p<0.05) with small effect sizes (Cohen's d: -0.16, 95% Confidence Interval: -0.32 to 0.00, at six-month follow-up). Conclusions: The present study first demonstrated that a computerized cognitive behavior therapy delivered via the Internet was effective in improving depression in the general working population. It seems critical to improve program involvement of participants in order to enhance the effect size of an iCBT program. Trial Registration: UMIN Clinical Trials Registry UMIN000006210.

AB - Objective: The purpose of this study was to develop a new Internet-based computerized cognitive behavior therapy (iCBT) program in Manga format, the Japanese cartoon, for workers and to examine the effects of the iCBT program on improving subthreshold depression using a randomized controlled trial (RCT) design among workers employed in private companies in Japan. Method: All workers in a company (n = 290) and all workers in three departments (n = 1,500) at the headquarters of another large company were recruited by an invitation e-mail. Participants who fulfilled the inclusion criteria were randomly allocated to intervention or control groups (N = 381 for each group). A six-week, six-lesson iCBT program using Manga (Japanese comic) story was developed. The program included several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem solving, and relaxation. The intervention group studied the iCBT program at a frequency of one lesson per week. Depression (Beck Depression Inventory II; BDI-II) was assessed as a primary outcome at baseline, and threeand six-month follow-ups for both intervention and control groups were performed. Results: The iCBT program showed a significant intervention effect on BDI-II (t = -1.99, p<0.05) with small effect sizes (Cohen's d: -0.16, 95% Confidence Interval: -0.32 to 0.00, at six-month follow-up). Conclusions: The present study first demonstrated that a computerized cognitive behavior therapy delivered via the Internet was effective in improving depression in the general working population. It seems critical to improve program involvement of participants in order to enhance the effect size of an iCBT program. Trial Registration: UMIN Clinical Trials Registry UMIN000006210.

UR - http://www.scopus.com/inward/record.url?scp=84901371447&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901371447&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0097167

DO - 10.1371/journal.pone.0097167

M3 - Article

C2 - 24844530

AN - SCOPUS:84901371447

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 5

M1 - e97167

ER -