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Smartphone apps effective for depression

Joseph Firth

Meta-analysis results indicated efficacy of smartphone apps for depressive symptoms.

“Digital technologies may represent a novel and viable solution. Mobile phones are among the most rapidly adopted innovations in recent history, and smartphone ownership continues to increase in both developed and developing countries,” Joseph Firth, BSc, of the Western Sydney University, Campbelltown, Australia, and colleagues wrote. “Through providing ubiquitous Internet connectivity, along with the capacity to download and run externally created applications (‘apps’), smartphone technology presents an opportunity to transform mobile phones into devices which could provide global, cost-effective and evidence-based mental health services on demand and in real time.”

To establish an evidence-base for smartphone apps in treatment of depression, researchers conducted a meta-analysis of 18 randomized controlled trials of 22 smartphone apps among 3,414 participants.

Participants who received smartphone app interventions had significantly lower depressive symptoms than control conditions (P < .001).

There was no evidence of publication bias, according to researchers.

Smartphone interventions had a moderate positive effect when compared with inactive controls and a small effect when compared with active control conditions.

Smartphone-only interventions were more effective than interventions that included other human/computerized aspects along with smartphones, although the difference was not statistically significant.

Cognitive training apps had significantly smaller effect sizes on depression outcomes vs. apps that focused on mental health.

Effect sizes were not significantly affected by mood monitoring software, interventions based on cognitive-behavioral therapy or apps using mindfulness training.

“The evidence to date indicates that mental health interventions delivered via smartphone devices can reduce depressive symptoms,” the researchers wrote. “However, delivering treatments via a smartphone introduces several new aspects which need to be considered, beyond the platform change alone. Specifically, we have yet to establish the ways in which user engagement, feedback loops, expectancy effects and individual patient characteristics influence intervention outcomes. Rather than a barrier, these variables represent new opportunities for further research to optimize and personalize smartphone-based interventions.” – by Amanda Oldt

Disclosures: Firth reports receiving funding from a Blackmores Institute Fellowship and a Medical Research Council doctoral training grant. Please see the study for all other authors’ relevant financial disclosures.