Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial
Abstract BackgroundThe prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive...
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JMIR Publications
2025-07-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e60943 |
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| author | Shinichiro Nagamitsu Ayumi Okada Ryoichi Sakuta Ryuta Ishii Kenshi Koyanagi Chizu Habukawa Takashi Katayama Masaya Ito Ayako Kanie Ryoko Otani Takeshi Inoue Tasuku Kitajima Naoki Matsubara Chie Tanaka Chikako Fujii Yoshie Shigeyasu Michiko Matsuoka Tatsuyuki Kakuma Masaru Horikoshi |
| author_facet | Shinichiro Nagamitsu Ayumi Okada Ryoichi Sakuta Ryuta Ishii Kenshi Koyanagi Chizu Habukawa Takashi Katayama Masaya Ito Ayako Kanie Ryoko Otani Takeshi Inoue Tasuku Kitajima Naoki Matsubara Chie Tanaka Chikako Fujii Yoshie Shigeyasu Michiko Matsuoka Tatsuyuki Kakuma Masaru Horikoshi |
| author_sort | Shinichiro Nagamitsu |
| collection | DOAJ |
| description |
Abstract
BackgroundThe prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive behavioral therapy (CBT), implemented it in healthy children, and reported its effectiveness for health promotion.
ObjectiveThis study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders.
MethodsThe participants were 115 children with mental health disorders (eg, school refusal, orthostatic hypotension, eating disorders, developmental disorders, among others) and aged 12‐18 years. The CBT app–based program comprised 1 week of psychoeducation followed by 1 week of self-monitoring. After reading story-like scenarios, participants created a self-monitoring sheet with 5 panels: events, thoughts, feelings, body responses, and actions. All participants received regular mental health care from physicians in addition to the app-based program. To evaluate the participants’ depressive symptoms and QOL, Patient Health Questionnaire for Adolescents (PHQ-9A), Depression Self-Rating Scale for Children (DSRS-C), and Pediatric Quality of Life Inventory (PedsQL) were measured at the beginning of the intervention, and at 2 and 6 months thereafter. Questionnaire for Triage and Assessment with 30 items (QTA30), and Rosenberg Self-Esteem Scale (RSES) were also used to measure their health and self-esteem. Participants were divided into 4 groups on the basis of the PHQ-9A score (above or below the cutoff; PHQ-9A≥5 or PHQ-9A<5) and completion or noncompletion of the CBT app–based program (app [+] or app [-]). The primary outcome was improvement in the DSRS-C score, and secondary outcomes were improvement in other psychometric scales including PedsQL, QTA30, and RSE. A paired-samples t
ResultsThere were 48, 18, 18, and 7 participants in the PHQ-9A≥5 app (+), PHQ-9A≥5 app (-), PHQ-9A<5 app (+), and PHQ-9A<5 app (-) groups, respectively. A total of 24 participants dropped out. No improvement in the DSRS-C score was observed in all groups. However, PedsQL scores improved significantly at 2 and 6 months in the PHQ-9A<5 app (+) group (t17Pt17P
ConclusionsThe CBT app was useful for improving PedsQL scores of children with mental health disorders. However, a higher-intensity CBT program is necessary for more severely depressed children. |
| format | Article |
| id | doaj-art-d7ef5d94d09e4a9382a2c577b8dfabba |
| institution | Kabale University |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj-art-d7ef5d94d09e4a9382a2c577b8dfabba2025-08-20T03:36:14ZengJMIR PublicationsJMIR Formative Research2561-326X2025-07-019e60943e6094310.2196/60943Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical TrialShinichiro Nagamitsuhttp://orcid.org/0000-0001-7156-6050Ayumi Okadahttp://orcid.org/0000-0002-9414-1650Ryoichi Sakutahttp://orcid.org/0000-0002-5444-0568Ryuta Ishiihttp://orcid.org/0000-0003-0326-7299Kenshi Koyanagihttp://orcid.org/0000-0002-6703-7436Chizu Habukawahttp://orcid.org/0000-0002-6611-1446Takashi Katayamahttp://orcid.org/0000-0002-0603-395XMasaya Itohttp://orcid.org/0000-0003-2295-9733Ayako Kaniehttp://orcid.org/0000-0001-8480-7001Ryoko Otanihttp://orcid.org/0000-0002-0668-6838Takeshi Inouehttp://orcid.org/0000-0002-7262-0482Tasuku Kitajimahttp://orcid.org/0000-0003-3333-7139Naoki Matsubarahttp://orcid.org/0000-0002-4233-7723Chie Tanakahttp://orcid.org/0000-0003-3920-4986Chikako Fujiihttp://orcid.org/0000-0002-0167-9065Yoshie Shigeyasuhttp://orcid.org/0000-0002-2469-7637Michiko Matsuokahttp://orcid.org/0000-0002-7481-9305Tatsuyuki Kakumahttp://orcid.org/0000-0002-3713-3099Masaru Horikoshihttp://orcid.org/0000-0001-9336-8813 Abstract BackgroundThe prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive behavioral therapy (CBT), implemented it in healthy children, and reported its effectiveness for health promotion. ObjectiveThis study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders. MethodsThe participants were 115 children with mental health disorders (eg, school refusal, orthostatic hypotension, eating disorders, developmental disorders, among others) and aged 12‐18 years. The CBT app–based program comprised 1 week of psychoeducation followed by 1 week of self-monitoring. After reading story-like scenarios, participants created a self-monitoring sheet with 5 panels: events, thoughts, feelings, body responses, and actions. All participants received regular mental health care from physicians in addition to the app-based program. To evaluate the participants’ depressive symptoms and QOL, Patient Health Questionnaire for Adolescents (PHQ-9A), Depression Self-Rating Scale for Children (DSRS-C), and Pediatric Quality of Life Inventory (PedsQL) were measured at the beginning of the intervention, and at 2 and 6 months thereafter. Questionnaire for Triage and Assessment with 30 items (QTA30), and Rosenberg Self-Esteem Scale (RSES) were also used to measure their health and self-esteem. Participants were divided into 4 groups on the basis of the PHQ-9A score (above or below the cutoff; PHQ-9A≥5 or PHQ-9A<5) and completion or noncompletion of the CBT app–based program (app [+] or app [-]). The primary outcome was improvement in the DSRS-C score, and secondary outcomes were improvement in other psychometric scales including PedsQL, QTA30, and RSE. A paired-samples t ResultsThere were 48, 18, 18, and 7 participants in the PHQ-9A≥5 app (+), PHQ-9A≥5 app (-), PHQ-9A<5 app (+), and PHQ-9A<5 app (-) groups, respectively. A total of 24 participants dropped out. No improvement in the DSRS-C score was observed in all groups. However, PedsQL scores improved significantly at 2 and 6 months in the PHQ-9A<5 app (+) group (t17Pt17P ConclusionsThe CBT app was useful for improving PedsQL scores of children with mental health disorders. However, a higher-intensity CBT program is necessary for more severely depressed children.https://formative.jmir.org/2025/1/e60943 |
| spellingShingle | Shinichiro Nagamitsu Ayumi Okada Ryoichi Sakuta Ryuta Ishii Kenshi Koyanagi Chizu Habukawa Takashi Katayama Masaya Ito Ayako Kanie Ryoko Otani Takeshi Inoue Tasuku Kitajima Naoki Matsubara Chie Tanaka Chikako Fujii Yoshie Shigeyasu Michiko Matsuoka Tatsuyuki Kakuma Masaru Horikoshi Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial JMIR Formative Research |
| title | Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial |
| title_full | Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial |
| title_fullStr | Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial |
| title_full_unstemmed | Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial |
| title_short | Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial |
| title_sort | usefulness of interventions using a smartphone cognitive behavior therapy application for children with mental health disorders prospective single arm uncontrolled clinical trial |
| url | https://formative.jmir.org/2025/1/e60943 |
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