Background: The social restrictions occurring during the pandemic contributed to loss of many sources of reward, which contributes to poor mental health.
Objective: This trial evaluated a brief positive affect training programme to reduce anxiety, depression and suicidality during the pandemic.
Methods: In this single-blind, parallel, randomised controlled trial, adults who screened positive for COVID-19-related psychological distress across Australia were randomly allocated to either a 6-session group-based programme based on positive affect training (n=87) or enhanced usual care (EUC, n=87). Primary outcome was total score on the Hospital Anxiety and Depression Scale-anxiety and depression subscales assessed at baseline, 1-week post-treatment, 3 months (primary outcome time point) as well as secondary outcome measures of suicidality, generalised anxiety disorder, sleep impairment, positive and negative mood and COVID-19-related stress.
Findings: Between 20 September 2020 and 16 September 2021, 174 participants were enrolled into the trial. Relative to EUC, at 3-month follow-up the intervention led to greater reduction on depression (mean difference 1.2 (95% CI 0.4 to 1.9)), p=0.003), with a moderate effect size (0.5 (95% CI 0.2 to 0.9)). There were also greater reduction of suicidality and improvement in quality of life. There were no differences in anxiety, generalised anxiety, anhedonia, sleep impairment, positive or negative mood or COVID-19 concerns.
Conclusions: This intervention was able to reduce depression and suicidality during adverse experiences when rewarding events were diminished, such as pandemics.
Clinical implications: Strategies to improve positive affect may be useful to reduce mental health issues.
Trial registration number: ACTRN12620000811909.
Keywords: COVID-19; anxiety disorders; depression & mood disorders; suicide & self-harm.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.