Patient Engagement, Health IT

Study of apps for depression notes positive impact of cognitive therapy intervention, mindfulness

The study identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants.

The buzz around behavioral health apps for identifying and managing depression is building to a dull roar. A new study evaluating apps supporting interventions published by the Journal of the World Psychiatric Association indicates that they are a promising self-management tool for depression, but that more (much more) research is needed to ascertain which specific aspects of these technologies produce beneficial effects, and for which populations.

The study identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants.

The study observed that since the clinical effect of smartphone interventions on symptoms of depression “has yet to be established,” the researchers sought to evaluate the efficacy of delivering mental health interventions through smartphones to reduce symptoms of depression. Even that isn’t easy, given the hype.

…in the enthusiasm to realize the potential of apps for depression, it has become difficult to separate actual efficacy from overzealous aspirational claims. With thousands of mental health apps readily available through Apple or Google marketplaces, finding a useful tool supported by robust evidence to manage one’s depression is clearly a challenge for a lay person.

The aims of the study were modest. These were self-help apps, as opposed to tools intended for clinical settings. Even so, there were plenty of takeaways from the study itself and what future studies should assess. Study co-author Dr. John Torous, co-director of the digital psychiatry program at Beth Israel Deaconess Medical Center in Boston, said in a phone interview that apps providing in-app feedback led to better outcomes compared with apps that did not.

Torous noted that apps that offered cognitive behavioral therapy-based interventions performed better than those apps that didn’t include this component. Apps with “mindfulness” — guided exercises for reflection, meditation and deep breathing also had a significant, positive impact. Cognitive feedback didn’t do well, nor did regular “mood monitoring”.

Torous was cautiously optimistic on the study’s findings.

“It is exciting to see the overall trend is an effect. It is a small effect, but they clearly aren’t making people feel more depressed,” he said. “There were signs they will help a little but not so powerful they will transform psychiatric care.  It’s better than having no effect or worse, a negative effect. These apps do something that could augment care, but it’s a long way towards assessing how well they would work in [other environments].” Even more importantly, why did some app components do better than others?

Looking ahead, Torous said he’d like to see studies of apps for depression look at age, gender, and employment as well as economic validation. But at the moment, he noted that companies aren’t yet sharing cost-effectiveness data.

Photo: KatarzynaBialasiewicz, Getty Images