Development and evaluation of an innovative CBT stress management program for prevention of depressive and anxiety disorders

• Project/Area Number: 18H04072
• Research Category: Grant-in-Aid for Scientific Research (A)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Medium-sized Section 58:Society medicine, nursing, and related fields
• Research Institution: The University of Tokyo
• Principal Investigator: Kawakami Norito 東京大学, 大学院医学系研究科(医学部), 教授 (90177650)
• Co-Investigator(Kenkyū-buntansha): 小山 博史 東京大学, 大学院医学系研究科(医学部), 教授 (30194640) ; 西 大輔 東京大学, 大学院医学系研究科(医学部), 准教授 (40450605) ; 今村 幸太郎 東京大学, 大学院医学系研究科(医学部), 特任講師 (80722793)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥34,190,000 (Direct Cost: ¥26,300,000、Indirect Cost: ¥7,890,000); Fiscal Year 2021: ¥6,500,000 (Direct Cost: ¥5,000,000、Indirect Cost: ¥1,500,000); Fiscal Year 2020: ¥8,580,000 (Direct Cost: ¥6,600,000、Indirect Cost: ¥1,980,000); Fiscal Year 2019: ¥8,840,000 (Direct Cost: ¥6,800,000、Indirect Cost: ¥2,040,000); Fiscal Year 2018: ¥10,270,000 (Direct Cost: ¥7,900,000、Indirect Cost: ¥2,370,000)
• Keywords: 産業精神保健 / 人工知能 / 認知行動療法 / 健康教育 / 無作為化比較試験 / 人口知能 / ストレスマネジメント / インターネット

Outline of Final Research Achievements

We developed a fully-automated AI-based Internet cognitive behavioral therapy (iCBT) program and tested its effectiveness for reducing depression among workers in a randomized controlled trial. We assigned 648 participants for each of intervention and control groups. The intervention group studied the AI-guided iCBT program "Mr Smart" for 10 weeks. The primary outcome is Beck Depression Inventory II score at 3- and 6-months. Eighty-five percent of the intervention group studied at least part of the program; and 54% studied all the program. The intervention effects at 3- and 6-month follow-ups were both significant (p=0.038 and 0.020, respectively). We concluded that the AI-guided iCBT program "Mr Smart" was effective in reducing depression among workers.

Academic Significance and Societal Importance of the Research Achievements

学習内容の定着のためのワークの支援をAIにより自動化したSMART-CBTプログラムでは、労働者における抑うつ軽減効果は３ヶ月、６ヶ月時点で有意であり、専門家支援型iCBTプログラムの効果量と同等であった。SMART-CBTは低コストで効果的なiCBTプログラムとして労働者の抑うつの予防・改善に活用できる可能性がある。

Research Products

• [Int'l Joint Research] アムステルダム自由大学(オランダ)
• [Int'l Joint Research] アムステルダム自由大学(オランダ)
• [Int'l Joint Research] ハーバード大学医学部(米国)
• [Journal Article] Experience, user satisfaction, and difficulties of online occupational health consultations during the COVID-19 pandemic: A cross-sectional survey of workers in Japan (2022)
  • Author(s): Ogawa Sayaka、Tomonaga Haruka、Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Imamura Kotaro、Kawakami Norito
  • Journal Title: SANGYO EISEIGAKU ZASSHI Volume: 64 Issue: 6 Pages: 345-353
  • DOI: 10.1539/sangyoeisei.2021-034-E
  • NAID: 130008141671
  • ISSN: 1341-0725, 1349-533X
  • Year and Date: 2022-11-20
• [Journal Article] COVID-19-related workplace bullying and customer harassment among healthcare workers over the time of the COVID-19 outbreak (2022)
  • Author(s): Iida Mako、Sasaki Natsu、Imamura Kotaro、Kuroda Reiko、Tsuno Kanami、Kawakami Norito
  • Journal Title: Journal of Occupational and Environmental Medicine Volume: Publish Ahead of Print Issue: 5 Pages: e300-e305
  • DOI: 10.1097/jom.0000000000002511
  • Peer Reviewed / Open Access
• [Journal Article] The Effect of the Imacoco Care Psychoeducation Website on Improving Psychological Distress Among Workers During the COVID-19 Pandemic: Randomized Controlled Trial (2022)
  • Author(s): Imamura Kotaro、Sasaki Natsu、Sekiya Yuki、Watanabe Kazuhiro、Sakuraya Asuka、Matsuyama Yutaka、Nishi Daisuke、Kawakami Norito
  • Journal Title: JMIR Formative Research Volume: 6 Issue: 3 Pages: e33883-e33883
  • DOI: 10.2196/33883
  • Peer Reviewed / Open Access
• [Journal Article] COVID‐19 vaccination did not improve employee mental health: A prospective study in an early phase of vaccination in Japan (2022)
  • Author(s): Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Imamura Kotaro、Kawakami Norito
  • Journal Title: Neuropsychopharmacology Reports Volume: 印刷中 Issue: 2 Pages: 230-232
  • DOI: 10.1002/npr2.12250
• [Journal Article] Deterioration in Mental Health Under Repeated COVID-19 Outbreaks Greatest in the Less Educated: A Cohort Study of Japanese Employees (2021)
  • Author(s): Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Imamura Kotaro、Kawakami Norito
  • Journal Title: Journal of Epidemiology Volume: 31 Issue: 1 Pages: 93-96
  • DOI: 10.2188/jea.JE20200499
  • NAID: 130007966033
  • ISSN: 0917-5040, 1349-9092
  • Year and Date: 2021-01-05
  • Peer Reviewed / Open Access
• [Journal Article] Sustained poor mental health among healthcare workers in COVID-19 pandemic: A longitudinal analysis of the four-wave panel survey over 8 months in Japan (2021)
  • Author(s): Sasaki Natsu、Asaoka Hiroki、Kuroda Reiko、Tsuno Kanami、Imamura Kotaro、Kawakami Norito
  • Journal Title: Journal of Occupational Health Volume: 63 Issue: 1 Pages: n/a
  • DOI: 10.1002/1348-9585.12227
  • NAID: 130008067509
  • ISSN: 1341-9145, 1348-9585
• [Journal Article] Changes in COVID-19 measures in the workplace: 8-month follow-up in a cohort study of full-time employees in Japan (2021)
  • Author(s): Asaoka Hiroki、Sasaki Natsu、Imamura Kotaro、Kuroda Reiko、Tsuno Kanami、Kawakami Norito
  • Journal Title: Journal of Occupational Health Volume: 63 Issue: 1 Pages: n/a
  • DOI: 10.1002/1348-9585.12273
  • NAID: 130008120348
  • ISSN: 1341-9145, 1348-9585
• [Journal Article] Changes in fears and worries related to COVID-19 during the pandemic among current employees in Japan: a 5-month longitudinal study (2021)
  • Author(s): Hidaka Y.、Sasaki N.、Imamura K.、Tsuno K.、Kuroda R.、Kawakami N.
  • Journal Title: Public Health Volume: 198 Pages: 69-74
  • DOI: 10.1016/j.puhe.2021.06.017
  • Peer Reviewed / Open Access
• [Journal Article] Effectiveness of an Internet-Based Machine-Guided Stress Management Program Based on Cognitive Behavioral Therapy for Improving Depression Among Workers: Protocol for a Randomized Controlled Trial (2021)
  • Author(s): Kawakami Norito、Imamura Kotaro、Watanabe Kazuhiro、Sekiya Yuki、Sasaki Natsu、Sato Nana、SMART-CBT Project Team
  • Journal Title: JMIR Research Protocols Volume: 10 Issue: 9 Pages: e30305-e30305
  • DOI: 10.2196/30305
  • Peer Reviewed / Open Access
• [Journal Article] Workplace Bullying and Patient Aggression Related to COVID-19 and its Association with Psychological Distress among Health Care Professionals during the COVID-19 Pandemic in Japan (2021)
  • Author(s): Asaoka Hiroki、Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Kawakami Norito
  • Journal Title: The Tohoku Journal of Experimental Medicine Volume: 255 Issue: 4 Pages: 283-289
  • DOI: 10.1620/tjem.255.283
  • NAID: 130008128312
  • ISSN: 0040-8727, 1349-3329
  • Peer Reviewed / Open Access
• [Journal Article] The Effects of Downloading a Government-Issued COVID-19 Contact Tracing App on Psychological Distress During the Pandemic Among Employed Adults: Prospective Study (2021)
  • Author(s): Kawakami Norito、Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Imamura Kotaro
  • Journal Title: JMIR Mental Health Volume: 8 Issue: 1 Pages: e23699-e23699
  • DOI: 10.2196/23699
  • Peer Reviewed / Open Access
• [Journal Article] Exposure to media and fear and worry about COVID‐19 (2020)
  • Author(s): Sasaki Natsu、Kuroda Reiko、Tsuno Kanami、Kawakami Norito
  • Journal Title: Psychiatry and Clinical Neurosciences Volume: 74 Issue: 9 Pages: 501-502
  • DOI: 10.1111/pcn.13095
  • Peer Reviewed / Open Access
• [Journal Article] Differences in the Effect of Internet-Based Cognitive Behavioral Therapy for Improving Nonclinical Depressive Symptoms Among Workers by Time Preference: Randomized Controlled Trial (2018)
  • Author(s): Imamura Kotaro、Furukawa Toshi A、Matsuyama Yutaka、Shimazu Akihito、Kuribayashi Kazuto、Kasai Kiyoto、Kawakami Norito
  • Journal Title: Journal of Medical Internet Research Volume: 20 Issue: 8 Pages: e10231-e10231
  • DOI: 10.2196/10231
  • Peer Reviewed / Open Access
• [Journal Article] Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis (2018)
  • Author(s): Karyotaki E, Ebert DD, ..., Imamura K (48人中28番目).
  • Journal Title: Clinical Psychology Review Volume: 63 Pages: 80-92
  • DOI: 10.1016/j.cpr.2018.06.007
  • Peer Reviewed / Int'l Joint Research
• [Presentation] 労働者におけるAI支援型認知行動療法プログラムの抑うつの改善効果：無作為化比較試験 (2022)
  • Author(s): 川上憲人、今村幸太郎、渡辺和広、関屋裕希、佐々木那津、松山 裕、SMART-CBTチーム
  • Organizer: 第29回日本産業ストレス学会
• [Presentation] Effect of Internet-based cognitive behavioural therapy (iCBT) in manga format on preventing major depressive episode among workers: A 12-month follow-up of a randomized controlled trial. (2019)
  • Author(s): Imamura K
  • Organizer: International Society for Research on Internet Interventions (ISRII)
  • Int'l Joint Research / Invited
• [Presentation] インターネット認知行動療法をRCTで検証する 労働者を対象としたインターネット認知行動療法(iCBT)のうつ病予防効果 (2018)
  • Author(s): 今村幸太郎, 川上 憲人, 古川 壽亮
  • Organizer: 第18回日本認知療法・認知行動療法学会
  • Invited