163. The promotional mechanism of rehabilitation management intervention on the mental health of depressed college students

Abstract Background Depression among college students has become a major global public health concern, with a detection rate of 23.8% in higher education. Among treated students, relapse rates reach 40–60%. Traditional interventions focus on acute symptom control but often neglect rehabilitation and functional recovery, leaving persistent impairments in social functioning. Rehabilitation management, as a systematic intervention, emphasizes multi-dimensional promotion of functional recovery and relapse prevention, showing good outcomes in chronic mental disorders. This study aimed to develop a structured rehabilitation management model for depressed college students and assess its effect on mental health. By examining multi-level indicators, the study also explored the underlying mechanisms, providing guidance for improving full-course management, reducing relapse, and promoting functional recovery. Methods A randomized controlled trial recruited 300 college students from five universities who had partially remitted symptoms after acute treatment, with Hamilton Depression Rating Scale-17 (HAMD-17) scores of 8–17. Participants were randomly assigned to a rehabilitation management group (n = 150) or a control group (n = 150). The rehabilitation group received a 24-week comprehensive intervention including: (1) Case management: biweekly assessments; (2) Functional rehabilitation training: twice-weekly cognitive training and weekly social skills training; (3) Lifestyle management: guidance on sleep, exercise, and nutrition; (4) Academic adaptation support; (5) Mobile app monitoring and real-time alerts. The control group received standard follow-up care. Primary outcomes were 24-week relapse rate and functional recovery rate. Secondary outcomes included HAMD-17, Montreal Cognitive Assessment (MoCA), General Self-Efficacy Scale (GSES), and Social Support Rating Scale (SSRS). Assessments were conducted at baseline, week 12 and 24. Results Baseline characteristics did not differ significantly between groups (p>.05). At 24 weeks, the rehabilitation group had a significantly lower relapse rate than controls (12.7% vs. 31.3%, p<.001) and higher functional recovery (68.7% vs. 42.0%, p<.001). HAMD-17 scores decreased to 5.8 ± 3.2 in the intervention group, significantly lower than 9.4 ± 4.6 in controls (p<.001, d = 0.91), with complete remission at 76.0%. MoCA scores rose from 24.3 ± 2.8 to 28.1 ± 1.6 (p<.001), GSES improved by 34.2% (p<.001), and SSRS increased by 28.6% (p<.001). Mediation analysis indicated that improvements in cognitive function, social support, and self-efficacy explained 32.6%, 28.4%, and 24.1% of the total effect, respectively, with a combined mediation of 63.8%. Program completion rate was 87.3%, and satisfaction averaged 8.6 ± 1.2. Discussion The study confirmed that comprehensive rehabilitation management significantly reduces relapse risk and promotes functional recovery in depressed college students. Improvements stemmed from biological effects, including reduced inflammation and enhanced neural plasticity, alongside psychological benefits such as better cognitive function, increased self-efficacy, and strengthened social support. These multi-level effects jointly contributed to the intervention’s efficacy. The findings support shifting depression management from focusing solely on symptom control to emphasizing functional recovery through a full-course service integrating acute treatment, rehabilitation, and relapse prevention. Rehabilitation management should be standardized in campus mental health services, particularly for students at risk of persistent functional impairment. Future research should expand sample size, extend follow-up to evaluate long-term effects, and explore tailored interventions for different depression subtypes to refine precision rehabilitation strategies for college populations. Funding No. 2024XLZX41.