%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 9
%N 
%P e60943
%T Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial
%A Nagamitsu,Shinichiro
%A Okada,Ayumi
%A Sakuta,Ryoichi
%A Ishii,Ryuta
%A Koyanagi,Kenshi
%A Habukawa,Chizu
%A Katayama,Takashi
%A Ito,Masaya
%A Kanie,Ayako
%A Otani,Ryoko
%A Inoue,Takeshi
%A Kitajima,Tasuku
%A Matsubara,Naoki
%A Tanaka,Chie
%A Fujii,Chikako
%A Shigeyasu,Yoshie
%A Matsuoka,Michiko
%A Kakuma,Tatsuyuki
%A Horikoshi,Masaru
%K smartphone
%K cognitive behavioral therapy
%K application
%K adolescent
%K youth
%K teen
%K pediatric
%K mental health
%K psychoeducation
%K self-monitoring
%K questionnaire
%K depressive symptoms
%K effectiveness
%K Japan
%K statistical analysis
%K single-arm uncontrolled study
%K mobile phone
%D 2025
%7 29.7.2025
%9 
%J JMIR Form Res
%G English
%X Background: The 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. Objective: This study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders. Methods: The 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 test was used for statistical analysis. The Medical Ethics Committee of Fukuoka University Faculty of Medicine (approval U22-05-002) approved the study design. Results: There 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 (t17=6.62; P<.001 and t17=6.11; P<.001, respectively). There was a significant positive correlation between the PHQ-9A scores and the number of self-monitoring sheets completed. Conclusions: The 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. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000046775; center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053360 
%R 10.2196/60943
%U https://formative.jmir.org/2025/1/e60943
%U https://doi.org/10.2196/60943