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Effect of digital intervention in the self-management of depressive symptoms: the MENTINA trial - a study protocol for a randomised controlled parallel-group trial

Por: Faurholt-Jepsen · M. · Dyreholt · M. S. · Kyster · N. B. · Iversen · N. · Kortsen · E. M. · Amann · B. L. · Hogg · B. · Gatto · D. · Cordoba · C. d. · Petrovic · M. · Allenhof · C. · Schnitzspahn · K. · Reich · H. · Budtz-Jorgensen · E. · Kessing · L. V. · Hegerl · U.
Introduction

Depression and sub-diagnostic depressive syndromes are prevalent and associated with suffering and reduced life expectancy. Access to care is limited even in countries with developed healthcare systems. In this context, it is important to strengthen the self-management expertise of people suffering from depressive symptoms. Smartphones offer the possibilities for improved self-management based on long-term monitoring of symptoms.

The present multicentre randomised controlled trial (the Protecting mental health in times of change (MENTINA) trial) aims to evaluate whether (1) daily smartphone-based monitoring and automatic rule-based feedback+smartphone-based outcome evaluations versus (2) smartphone-based outcome evaluations alone will improve depressive symptoms and other clinically relevant outcomes in participants with current depressive symptoms and/or one or more prior depressive episodes during a 12-month trial period.

Methods and analysis

The MENTINA trial is a multicentre randomised controlled parallel-group trial conducted in Denmark, Germany and Spain. Participants with current depressive symptoms and/or one or more previous depressive episodes are invited to participate. The included participants will be randomised to (1) daily smartphone-based monitoring and automatic rule-based feedback+outcome evaluations via smartphone (intervention group) or (2) outcome evaluations via smartphone alone (control group). All participants can continue with ongoing treatment in case they receive it. The trial started in May 2025 and has currently included 115 participants. The outcomes are differences between the intervention group and the control group in (1) Patient Health Questionnaire 9-items (PHQ-9) measured every 14th day during the 12-month trial period (primary), (2) WHO Quality of Life-BREF, Generalised Anxiety Disorder-7, monthly change in PHQ-9, proportion of participants with ≥50% reduction in PHQ-9, remission rate defined as PHQ-9≤9 and ≥5-point improvement, PHQ-9 scores after 6 months, area under the curve for PHQ-9 over the 12 months trial period, subgroup analyses in PHQ-9 in participants with or without lifetime depression, Perceived Stress Scale, user-reported healthcare contacts, usability of the app and negative effects, number of depressive episodes+duration and depressive-free days based on PHQ-9. A total of 660 participants will be included in the MENTINA trial.

Ethics and dissemination

The MENTINA trial is funded by the European Union under Grant Agreement No. 101 080 651. Ethical approval and approval from Medical Agencies have been obtained from Denmark (CIV-25-02-051094), Germany (CIV-25-02-05109) and Spain (CIV-25-02-051094). The results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated to patients’ organisations and media outlets.

Trial registration number

NCT06919133.

Protocol version

Version 6, January 2026.

School-to-work transition: The role of life satisfaction, risk perception, and resilience in youth career decision-making

by Petar Stanimirović, Tea Borozan, Katarina Petrović, Dragan Bjelica, Zorica Mitrović, Marko Mihić, Dejan Petrović, Anđelija Đorđević Tomić

Young people often face uncertainty during the transition from education to work, along with high unemployment and job dissatisfaction, which is addressed in the EU Youth Strategy, highlighting the need for better career support. This study aimed to identify main factors influencing youth career decisions and to develop a decision-making model. Five core constructs were defined through literature review: Dealing with Uncertainty, Risk Preference, Adaptability and Resilience, Education and Support, and Life Satisfaction. Data were collected from 673 engineering students. Regression analysis was used to test the proposed model and hypotheses, while Mann-Whitney and Kruskal-Wallis tests examined group differences. The developed model accounts for 46.2% (R² = 0.462) of the variability in students’ career choices. Adaptability and resilience emerged as the most influential factor (β = 0.557). Certain differences, for specific constructs, were also observed in relation to different groups of family income, gender and extracurricular activity engagement. The model supports more informed career decisions and provides insights that may help improve career guidance and educational policy. The findings also may contribute to bridging theory and practice in career development research. The study is limited by its sample, which included only engineering students from the Republic of Serbia, potentially restricting the generalizability of the results.

Emergency physicians experiences managing patients with a suspected cancer diagnosis in Ontario, Canada: a qualitative study

Por: Moore · C. · Petrovic · B. · Bender · J. L. · Thompson · C. · McLeod · S. L. · Savage · D. · Borgundvaag · B. · Ovens · H. · Irish · J. · Eskander · A. · Cheskes · S. · Krzyzanowska · M. · de Wit · K. · Mohindra · R. · Thiruganasambandamoorthy · V. · Grewal · K.
Objective

The emergency department (ED) often serves as a crucial pathway for cancer diagnosis. However, little is known about the management of patients with new suspected cancer diagnoses in the ED. The objective of this study was to explore emergency physicians’ experiences in managing patients with a newly suspected cancer diagnosis in the ED.

Design

Between January and April 2024, we conducted a qualitative descriptive study. Interviews were conducted by trained research personnel using a semistructured interview guide. Interviews were conducted until thematic saturation was achieved. The interview transcripts were coded and thematic analysis was used to uncover key themes.

Setting and participants

Emergency physicians practising in Ontario, Canada.

Results

20 emergency physicians were interviewed. Four themes around the management of patients with new suspected cancer diagnoses in the ED were identified: (1) healthcare system-level factors that impact suspected cancer diagnosis through the ED, (2) institutional and provider-level challenges associated with managing patients with a suspected cancer diagnosis in the ED, (3) patient-level characteristics and experiences of receiving a cancer diagnosis in the ED and (4) the need for care coordination for patients with suspected cancer in the ED.

Conclusions

Physicians experienced several unique challenges in managing patients with a suspected cancer diagnosis in the ED. Overall, the findings of this study suggest these challenges often make the ED a difficult environment in which to deliver a suspected cancer diagnosis.

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