Effectiveness of network analysis-driven personalized digital interventions versus standard intervention for depression: a proof-of-concept pilot randomized controlled trial.

While a growing number of studies have highlighted the relevance of core and bridge symptoms as potential intervention targets by following the network approach to  psychopathology, their findings have remained primarily descriptive or retrospective. To date, no study has prospectively tested whether interventions tailored to person-specific symptom networks can improve clinical outcomes compared to standard interventions. To address this gap, we conducted an exploratory investigation to examine whether a network-driven, person-specific sequencing of modules yields signals of added benefit compared with a standardized sequence. Accordingly, this proof-of-concept pilot randomized controlled trial recruited participants aged 18-29 years with depressive symptoms, and the Mini International Neuropsychiatric Interview was administered in person to screen for psychiatric conditions. The study compared a digital intervention program, consisting of up to 9 sessions plus one psychoeducation session, sequenced according to core symptoms identified through network analysis using 10-day ecological momentary assessment (EMA) collected beforehand, with a standardized fixed-sequence intervention. Depressive symptoms were measured using the, which includes one item assessing thoughts of self-harm or suicide, at post-intervention, and at 1- and 3-months follow-up. In total, 62 participants were randomly assigned to one of two intervention groups in a 1:1 ratio, with 31 participants in each group. An intent-to-treat analysis revealed significant improvements in depressive symptoms over time in both groups (p