Efficacy and Usability of a Digital Intervention for Stress Reduction in the Treatment of Depression: A Randomized Controlled Trial

Abstract In recent years, digital health interventions have proven effective for treating depression. However, it remains unclear which therapeutic components drive these effects, and the effectiveness of digital stress reduction interventions is under-researched. The present RCT investigated the effectiveness of a four-week self-guided digital stress regulation intervention in individuals with depression. After confirming the diagnosis of major depression, we randomly assigned N = 62 adults to either a control group receiving treatment as usual or to a digital intervention group receiving an additional digital stress regulation intervention. Self-reported depressive symptoms were our primary outcome. Secondary outcomes included anxiety, perceived stress, quality of life, usability and participant satisfaction. Descriptively, depressive symptoms improved in both groups with larger decreases in the digital intervention group at post-treatment (T0: M = 13.48, SD = 4.90; T1: M = 13.00, SD = 4.80) compared to the control group (T0: M = 14.26, SD = 3.69; T1: M = 14.11, SD = 4.80). However, compared to treatment as usual alone, the stress regulation intervention neither led to a significant reduction in depressive symptoms (F(2, 97.47) = 0.77, p = .464) nor to a significant improvement in any of the secondary outcomes. On average, participants rated the intervention’s usability as good and expressed medium to high user satisfaction. Our findings suggest that digital stress regulation interventions may be a feasible option for individuals with depression. Nevertheless, contrary to previous studies, our results do not provide evidence of superiority over treatment as usual alone.