Background The prevalence of depressive and anxiety symptoms in patients with COVID-19 is higher than usual. Previous studies have shown that there are drug-to-drug interactions between antiretroviral drugs and antidepressants. Therefore, an effective and safe treatment method was needed. Cognitive behavioral therapy (CBT) is the first-line psychological therapy in clinical treatment. Computerized CBT (cCBT) was proven to be an effective alternative to CBT and does not require face-to-face therapy between a therapist and the patient, which suited the COVID-19 pandemic response. Objective This study aims to evaluate the efficacy of the cCBT program we developed in improving depressive and anxiety symptoms among patients with COVID-19. Methods We customized a cCBT program focused on improving depressive and anxiety symptoms among patients with COVID-19, and then, we assessed its effectiveness. Screening was based on symptoms of depression or anxiety for patients who scored ≥7 on the Hamilton Depression Rating Scale (HAMD 17 ) or the Hamilton Anxiety Scale (HAMA). A total of 252 patients with COVID-19 at five sites were randomized into two groups: cCBT + treatment as usual (TAU; n=126) and TAU without cCBT (n=126). The cCBT + TAU group received the cCBT intervention program for 1 week. The primary efficacy measures were the HAMD 17 and HAMA scores. The secondary outcome measures were the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Athens Insomnia Scale (AIS). Assessments were carried out pre- and postintervention. The patients’ symptoms of anxiety and depression in one of the centers were assessed again within 1 month after the postintervention assessment. Results The cCBT + TAU group displayed a significantly decreased score on the HAMD 17 , HAMA, SDS, SAS, and AIS after the intervention compared to the TAU group (all P <.001). A mixed-effects repeated measures model revealed significant improvement in symptoms of depression (HAMD 17 and SDS scores, both P <.001), anxiety (HAMA and SAS scores, both P <.001), and insomnia (AIS score, P =.002) during the postintervention and follow-up periods in the cCBT + TAU group. Additionally, the improvement of insomnia among females ( P =.14) and those with middle school education ( P =.48) in the cCBT + TAU group showed no significant differences when compared to the TAU group. Conclusions The findings of this study suggest that the cCBT program we developed was an effective nonpharmacological treatment for symptoms of anxiety, depression, and insomnia among patients with COVID-19. Further research is warranted to investigate the long-term effects of cCBT for symptoms of anxiety, depression, and insomnia in patients with COVID-19. Trial Registration Chinese Clinical Trial Registry ChiCTR2000030084; http://www.chictr.org.cn/showprojen.aspx?proj=49952
【저자키워드】 COVID-19, Treatment, Anxiety, Depression, mental health, cCBT, computerized cognitive behavioral therapy, 【초록키워드】 Efficacy, CBT, cCBT, COVID-19 pandemic, Intervention, Symptom, drug, antidepressants, cognitive behavioral therapy, Screening, Prevalence, Registration, Randomized, clinical, antiretroviral drugs, female, Research, Patient, Effectiveness, Tau, Insomnia, scale, registry, assessment, Clinical treatment, Safe, treatment method, intervention program, SAS, middle school, behavioral therapy, no significant differences, two groups, follow-up period, no significant difference, Previous studies, assessments, Chinese, measure, Athens Insomnia Scale, cCBT + TAU group, cCBT program, Computerized CBT, depressive, drug-to-drug interactions, face-to-face therapy, HAMA, HAMD, Hamilton Anxiety Scale, Hamilton Depression Rating Scale, postintervention, secondary outcome measures, Self-Rating Anxiety Scale, Self-Rating Depression Scale, TAU group, therapist, previous study, antiretroviral drug, psychological therapy, Effect, objective, FIVE, effective, Drug-to-drug interaction, anxiety symptom, Result, shown, evaluate, carried, significantly, the patient, AIS, cCBT + TAU, cCBT intervention, nonpharmacological treatment, patients with COVID-19, repeated measure, scored, SDS, secondary outcome measure, symptoms of depression, treatment as usual, were assessed, 【제목키워드】 Controlled,