Internet Interventions · Published 2026-03-29 · DOI 10.1016/j.invent.2026.100939
Background: 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. Methods: 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). Results: 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. Conclusions: 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.
Abstract from DOAJ. Public domain (CC0 1.0).
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