The Impact of Cognitive Behavioral Therapy on Anxiety and Depression in University Students
DOI:
https://doi.org/10.53350/pjmhs02025191.3Keywords:
Keywords: Cognitive Behavioral Therapy, Anxiety, Depression, University Students, Mental Health, GAD-7, PHQ-9, Pakistan.Abstract
Background: Many academic and social stressors make university students highly susceptible to psychological disorders, in particular, anxiety and depression. However, Cognitive Behavioral Therapy (CBT) has been a promising treatment for such disorders around the globe, but has been under-studied in South Asian academic settings.
Aim: To evaluate the efficacy of CBT in reducing anxiety and depression among university students in Pakistan.
Methods: The study was carried out as a randomized controlled trial from June 2023 to June 2024 at The University of Lahore’s Institute of Molecular Biology and Biotechnology (IMBB) and CRIMM. For this purpose, a total of 120 students with mild to moderate anxiety or depression were randomly assigned to a CBT intervention group (n = 60) or a control group that received standard counseling (n = 60). GAD7 and PHQ-9 measures were used to determine the levels of anxiety and depression at baseline and after the intervention. Paired t tests and ANCOVA were used to analyze the data.
Results: Thus, post-intervention, the GAD-7 scores (mean change = −6.3, p < 0.001) and PHQ-9 scores (mean change = −7.1, p < 0.001) decreased significantly in the CBT group relative to minimal changes in the control group (GAD-7 = −1.7, PHQ-9 = 1.7). Response rates were over 70%, and the effect sizes were large in the CBT group. There were no adverse events or dropouts.
Conclusion: In addition, CBT is considerably more effective than standard counseling in reducing anxiety and depression in university students. Structured CBT programs should be integrated within campus mental health services.
References
Fernández-Rodríguez C, Soto-López T, Cuesta M. Needs and demands for psychological care in university students. Psicothema. 2019;31:414–21.
Sahmurova A, Arikan S, Gursesli MC, Duradoni M. ADHD symptoms as a stressor leading to depressive symptoms among university students: the mediating role of perceived stress between ADHD and depression. J Environ Res Public Health. 2022;19:11091.
Salla J, Galéra C, Guichard E, Tzourio C, Michel G. ADHD symptomatology and perceived stress among French college students. J AttenDisord. 2019;23:1711–8
Kiraz S, Sertcelik S. Adult attention deficit hyperactivity disorder and early maladaptive schemas. Clinic Psyc&Psychotherpy. 2021;28:1055–64.
Pan M-R, Zang S-Y, Chen C-L, Qiu S-W, Liu L, Li H-M, Zhao M-J, Dong M, FF SI, Wang Y-F, Qian Q-J. Bidierectional associations between maladaptive cognitions and emotional symtoms, and their mediating role on the quality of life in adults with ADHD: a mediation model. Front Psychiatry. 2023;14:1200522.
Philipsen A, Lam AP, Breit S, Lücke C, Müller HH, Matthies S. Early maladaptive schemas in adult patients with attention deficit hyperactivity disorder. ADHD Atten Def HypDisord. 2017;9:101–
Sibley MH, Graziano PA, Ortiz M, Rodriguez L, Coxe S. Academic impairment among high school students with ADHD: the role of motivation and goal-directed executive functions. J Sch Psychol. 2019;77:67–76
Riglin L, Leppert B, Dardani C, Thapar AK, Rice F, O’Donovan MC, Smith GD, Stergiakouli E, Tilling K, Thapar A. ADHD and depression: investigating a causal explanation. Psychol Med. 2021;51:1890–7
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington: American Psychiatric Association; 2013. p. 31–66.
LorenzoBalducci DIR, Cutino J, Latella A, Venturi E, Rovesti G, Filippini T, Ferri P. Adhd follow-up in adulthood among subjects treated for the disorder in a child and adolesent mental health service form 1995 to 2015. Medicina. 2023;59:338.
Faheem M, Akram W, Akram H, Khan MA, Siddiqi FA, Majeed I. Gender-based differences in prevalence and effects of ADHD in adults: a systematic review. Asian J Psychiatr. 2022;75:103205.
Jhawar N, Antshel KM. Understanding ADHD in AAPI college students: prevalence, comorbidities, impairments, and treatment utilization. J Atten Disord. 2024;28:243–53
National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults. 2018.
Kosheleff AR, Mason O, Jain R, Koch J, Rubin J. Functional impairments associated with ADHD in adulthood and the impact of pharmacological treatment. J AttenDisord. 2023;27:669–97.
Elliott J, Johnston A, Husereau D, Kelly SE, Eagles C, Charach A, et al. Pharmacologic treatment of attention deficit hyperactivity disorder in adults: a systematic review and network meta-analysis. PLoS ONE. 2020;15: e0240584.
Chaulagain A, Lyhmann I, Hamøy A, Widding-Havneraas T, Nyttingnes O, Bjelland I, Mykletun A. A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder. Eur Psychiatry. 2023;17: e90.
Liu C-I, Hua M-H, Lu M-L, Goh KK. Effectiveness of cognitive behavioural-based interventions for adults with attention-deficit/hyperactivity disorder extends beyond core symptoms: a meta-analysis of randomized controlled trials. PsycholPsychother. 2023;96:543–59.
Shahid R, Akram M, Ayub M, Nadeem M, Fatima E, Haroon AM, Batool F, fatima Fatima M. Prevalence and Correlates of Psychiatric Symptoms Among Medical Students in Punjab: A Comprehensive Cross-Sectional Study: Mental Health Insights: Psychiatric Symptoms Among Punjab Medical Students. Developmental Medico-Life-Sciences. 2024 Jul 13;1(3):13-9.
Downloads
How to Cite
Issue
Section
License
Copyright (c) 2025 MUHAMMAD NASIR SHAHBAZ, ARSLAN SHUJA, MUZNA KASHIF, MAMOONA SHUJA
This work is licensed under a Creative Commons Attribution 4.0 International License.
