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The purpose of this study was to test the effectiveness, and the sustained effect (follow-up) of a fourweek mindfulness intervention in reducing anxiety and stress in a group of Brazilian university students, the intervention was adapted to be made available through the application Neurosaúde, created as part of this work to serve as a platform for intervention. The research as a whole took place in a virtual environment, with forty-eight participants recruited who were randomly allocated to the intervention group or to the waiting list control. Measures were used to access the levels of mindfulness, anxiety and stress before, after the intervention and at the 4-week follow-up. Applying the intention-to-treat analysis, we found significant differences between the groups for the measurement of anxiety in the follow-up with a large feat size (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Our results suggest that the 4-week mindfulness intervention through a mobile application was able to act as a protective factor against the anxiety developed by university students during the occurrence of the pandemic caused by Covid-19, whereas while the treatment group maintained levels reduced anxiety the control group demonstrated a continuous increase in anxiety in the post-test and follow-up that coincided with the first wave of Covid-19 in the region where the participants lived.

El propósito de este estudio fue probar la eficacia y el efecto sostenido (seguimiento) de una intervención de atención plena de cuatro semanas para reducir la ansiedad y el estrés en un grupo de estudiantes universitarios brasileños, la intervención se adaptó para estar disponible a través del app. Neurosaúde, creada como parte de este trabajo para servir como plataforma de intervención. La investigación en su conjunto se llevó a cabo en un entorno virtual, siendo reclutados cuarenta y ocho participantes que fueron asignados aleatoriamente al grupo de intervención o al control en lista de espera. Se utilizaron medidas para evaluar los niveles de atención plena, ansiedad y estrés antes, después de la intervención y en el seguimiento a las 4 semanas. Al aplicar el análisis por intención de tratar, encontramos diferencias significativas entre los grupos para la medida de ansiedad en el seguimiento con un tamaño de efecto grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nuestros resultados sugieren que la intervención de mindfulness de 4 semanas a través de una aplicación móvil fue capaz de actuar como factor protector contra la ansiedad desarrollada por estudiantes universitarios durante la ocurrencia de la pandemia de Covid-19, ya que mientras el grupo de tratamiento mantuvo niveles, el grupo control demostró un aumento continuo de la ansiedad en el postest y seguimiento que coincidió con la primera ola de Covid-19 en la región donde residían los participantes.

O propósito deste estudo foi testar a eficácia e o efeito sustentado (follow-up) de uma intervenção de mindfulness de quatro semanas na redução da ansiedade e estresse em um grupo de estudantes universitários brasileiros. A intervenção foi adaptada para ser disponibilizada pelo aplicativo Neurosaúde, criado como parte deste trabalho para servir de plataforma para a intervenção. A pesquisa como um todo ocorreu em ambiente virtual, sendo recrutados 48 participantes que foram alocados randomicamente para o grupo intervenção ou para o controle de lista de espera. Medidas foram utilizadas para acessar os níveis de mindfulness, ansiedade e estresse antes, após a intervenção e no follow-up de quatro semanas. Aplicando a análise por intenção de tratar, encontramos diferenças significativas entre os grupos para a medida de ansiedade no follow-up com um tamanho de efeito grande (F (2.92) = 10.275, p = 0.000, η2 = 0.183). Nossos resultados sugerem que a intervenção de mindfulness de quatro semanas por meio de um aplicativo móvel foi capaz de agir como um fator protetor contra a ansiedade desenvolvida pelos estudantes universitários durante a ocorrência da pandemia causada pelo Covid-19, visto que, enquanto o grupo tratamento manteve níveis reduzidos de ansiedade, o grupo controle demonstrou um contínuo aumento de ansiedade no pós-teste e follow-up que coincidiu com a primeira onda de Covid-19 na região onde os participantes residiam.

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Specific psychological treatments for depressive disorders delivered on the Internet have shown effectiveness and presented advantages over face-to-face treatments (potentially less expensive, flexible schedules, available in remote areas). This paper aims to describe the characteristics of those who sought help from an online self-guided intervention for depression and to explore hypotheses about predictors of enrollment to the program. Based on a sample of 282 of individuals who filled in screening questionnaires, we verified that the respondents were mainly female, were on average 34.36 years old, were primarily recruited through Facebook, had been previously diagnosed by mental health professionals, presented moderate self-efficacy perception, and had moderately severe symptoms of depression. Respondents who reported comorbid conditions were more likely to attend enrollment interviews, and being in treatment or not did not influence attendance. Such characterization may provide strategies to reach more people and to optimize the design of interventions targeting help-seeking depressed individuals in Brazil.

Alguns tratamentos para a depressão baseados na Internet se mostraram efetivos e apresentaram vantagens em relação a tratamentos presenciais (potencialmente menos caros, com horários mais flexíveis e com disponibilidade em áreas remotas). Este artigo descreve as características de indivíduos que procuraram ajuda de uma intervenção autoguiada on-line e explora hipóteses sobre preditores de adesão ao programa. Baseado em uma amostra de 282 indivíduos que preencheram questionários de triagem, verificou-se que os participantes eram majoritariamente mulheres, tinham em média 34,36 anos, foram recrutados em sua maioria pelo Facebook, apresentaram diagnóstico psiquiátrico prévio feito por algum profissional de saúde mental, apresentaram percepção de autoeficácia moderada e sintomas depressivos moderadamente severos. Os respondentes que relataram condições comórbidas apresentaram mais chances de avançar para as entrevistas diagnósticas, e estar ou não em tratamento não influenciou a chegada às entrevistas. Estas descrições podem auxiliar na identificação de estratégias para se atingir mais indivíduos e para otimizar o desenho das intervenções on-line para brasileiros que as buscam.

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Although psychological treatments for depressive disorders are available, they are often expensive or inaccessible for many. Web-based interventions that require minimal or no contact with therapists have been shown effective. To the best of our knowledge, no study using this treatment format has been conducted in Brazil. The Deprexis program was designed using empirically established principles of cognitive-behavioral therapy to reduce depressive symptoms. The objective of this study was to evaluate the effectiveness of Deprexis in Brazil. This randomized controlled trial will include 128 Brazilians with clinically significant depression symptoms or who have been diagnosed with depressive disorder (major depressive disorder or dysthymia), recruited over the internet (Brazilian forums, social networks, or e-mail lists). Individuals with other psychiatric diagnoses that require significant attention (e.g., bipolar disorder, psychosis) will not be included in the trial. Participants will be randomly assigned to 1) treatment as usual plus immediate access to Deprexis or 2) treatment as usual plus delayed access to Deprexis (after 8 weeks). Participants will be able to obtain other treatment types in addition to the online intervention. If found effective, this web-based intervention would increase the evidence-based care options for depression treatment in Brazil. Clinical trial registration: RBR-6kk3bx, UTN U1111-1212-8998

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BACKGROUND: There is evidence of a high prevalence of depression and anxiety in university students. Therefore, college time is a key period where prevention of mental disorders through interventions that promote resilience and mental health can be relevant. Currently, there are interventions available, but these are insufficient for those who need them. Online interventions are tools that can facilitate global accessibility and are easy for young people to use. CORE (Cultivating Our Resilience) is a self-administered online program, based on Ryff's psychological well-being model, to promote resilience and coping skills in university students at risk of developing symptoms of depression or anxiety. The objective is to evaluate the effectiveness of this intervention protocol in comparison with an active control condition targeting healthy lifestyle, and a waiting list control condition. The study will be conducted in four populations of Spanish-speaking university students (Spain, Argentina, Colombia, and Mexico). METHODS: The study design is a randomized controlled trial (RCT). At least 324 university students will be randomly assigned to three conditions: 1) CORE, a 6-week training program to improve resilience; 2) HLP, a 6-week training to promote a healthy lifestyle; and 3) WL, waiting list control condition. The primary outcome measure will be the Connor-Davidson resilience scale. Additionally, measures of anxiety, depression, quality of life and socio-demographic variables (age, sex, incomes, marital status, among others) will be collected. Participants will be evaluated at pre-treatment, after each module, 6 weeks after allocation, and at 3-month follow-up. Intention-to-treat and per-protocol analyses will be performed. DISCUSSION: The results of this study will contribute to research on Internet-administered interventions and the implementation of a protocol that includes a series of components designed to improve resilience and coping skills, increase psychological well-being, and prevent depression and anxiety disorders in Spanish-speaking university students. In addition, avenues will be opened up for new research on the effectiveness of these interventions focused on the prevention and promotion of mental health in Spanish-speaking countries. TRIAL REGISTRATION: Registered at ClinicalTrials.gov NCT03903978 on April 2, 2019.

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