The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials.

App-supported smartphone interventions anxiety depression general psychiatric distress mental health problems positive affect psychological treatments

Journal

World psychiatry : official journal of the World Psychiatric Association (WPA)
ISSN: 1723-8617
Titre abrégé: World Psychiatry
Pays: Italy
ID NLM: 101189643

Informations de publication

Date de publication:
Oct 2019
Historique:
entrez: 10 9 2019
pubmed: 10 9 2019
medline: 10 9 2019
Statut: ppublish

Résumé

Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=-0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=-0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.

Identifiants

pubmed: 31496095
doi: 10.1002/wps.20673
pmc: PMC6732686
doi:

Types de publication

Journal Article

Langues

eng

Pagination

325-336

Informations de copyright

© 2019 World Psychiatric Association.

Références

Biometrics. 2000 Jun;56(2):455-63
pubmed: 10877304
Stat Med. 2002 Jun 15;21(11):1539-58
pubmed: 12111919
Psychol Bull. 1992 Jul;112(1):155-9
pubmed: 19565683
Cogn Behav Ther. 2009;38(4):196-205
pubmed: 20183695
JAMA. 2010 May 19;303(19):1976-7
pubmed: 20483977
Clin Psychol Rev. 2010 Aug;30(6):768-78
pubmed: 20619943
J Med Internet Res. 2012 Jun 25;14(3):e67
pubmed: 22732135
Psychol Serv. 2013 Aug;10(3):315-322
pubmed: 23937091
BMC Psychiatry. 2013 Nov 18;13:312
pubmed: 24237617
BMJ Open. 2014 Jan 09;4(1):e003440
pubmed: 24413342
Psychol Med. 2015 Jan;45(2):231-46
pubmed: 25065653
Behav Res Ther. 2014 Dec;63:122-31
pubmed: 25461787
Cyberpsychol Behav Soc Netw. 2015 Jan;18(1):46-53
pubmed: 25584730
Diabetes Care. 2015 May;38(5):776-83
pubmed: 25710923
Curr Psychiatry Rep. 2015 Aug;17(8):602
pubmed: 26073363
Games Health J. 2015 Jun;4(3):235-46
pubmed: 26182069
Behav Res Ther. 2015 Sep;72:72-80
pubmed: 26196078
Psychol Med. 2015 Oct;45(13):2691-704
pubmed: 26220802
Front Psychiatry. 2015 Jul 14;6:96
pubmed: 26236242
Epidemiol Psychiatr Sci. 2016 Oct;25(5):428-435
pubmed: 26411384
Games Health J. 2016 Feb;5(1):50-67
pubmed: 26536488
Health Psychol. 2015 Dec;34S:1220-8
pubmed: 26651463
Clin Psychol Rev. 2016 Feb;43:1-16
pubmed: 26655959
JMIR Mhealth Uhealth. 2016 Jan 26;4(1):e8
pubmed: 26813737
J Med Internet Res. 2016 Jan 27;18(1):e21
pubmed: 26818683
Occup Environ Med. 2016 May;73(5):315-23
pubmed: 26884049
JMIR Ment Health. 2016 Mar 01;3(1):e7
pubmed: 26932350
Clin Psychol Rev. 2016 Apr;45:102-14
pubmed: 27111302
Scand J Work Environ Health. 2016 Sep 1;42(5):382-94
pubmed: 27249161
J Med Internet Res. 2016 Sep 27;18(9):e255
pubmed: 27678169
J Anxiety Disord. 2016 Dec;44:27-35
pubmed: 27721123
J Consult Clin Psychol. 2017 Feb;85(2):160-177
pubmed: 27775414
J Med Internet Res. 2016 Dec 20;18(12):e330
pubmed: 27998876
Aging Ment Health. 2018 Apr;22(4):526-534
pubmed: 28071929
Behav Res Ther. 2017 Jan;88:19-25
pubmed: 28110672
Behav Res Ther. 2017 Jan;88:7-18
pubmed: 28110678
BMJ Open. 2017 Jan 27;7(1):e013518
pubmed: 28132007
J Med Internet Res. 2017 Feb 17;19(2):e32
pubmed: 28213341
J Consult Clin Psychol. 2017 Mar;85(3):267-273
pubmed: 28221061
JMIR Res Protoc. 2017 Apr 04;6(4):e51
pubmed: 28377368
J Med Internet Res. 2017 Apr 11;19(4):e70
pubmed: 28400355
J Affect Disord. 2017 Aug 15;218:15-22
pubmed: 28456072
Biol Psychol. 2017 Jul;127:148-156
pubmed: 28478138
J Consult Clin Psychol. 2017 Nov;85(11):1104-1108
pubmed: 28857576
World Psychiatry. 2017 Oct;16(3):287-298
pubmed: 28941113
Expert Rev Neurother. 2018 Jan;18(1):21-28
pubmed: 29094622
Cogn Behav Ther. 2018 Jan;47(1):1-18
pubmed: 29215315
Behav Modif. 2017 Dec 1;:145445517748561
pubmed: 29262693
JMIR Ment Health. 2018 Jan 23;5(1):e2
pubmed: 29362209
J Occup Environ Med. 2018 Jun;60(6):559-568
pubmed: 29370014
Behav Ther. 2018 Jan;49(1):71-83
pubmed: 29405923
Psychol Health. 2018 Sep;33(9):1079-1099
pubmed: 29609475
J Med Internet Res. 2018 Apr 23;20(4):e136
pubmed: 29685870
J Occup Health Psychol. 2019 Feb;24(1):127-138
pubmed: 29723001
J Consult Clin Psychol. 2018 Jun;86(6):493-504
pubmed: 29781648
Thorax. 2019 Jan;74(1):33-42
pubmed: 29793970
J Child Psychol Psychiatry. 2019 Apr;60(4):455-472
pubmed: 29900543
BJPsych Open. 2018 Jul 25;4(4):307-312
pubmed: 30083384
Behav Res Ther. 2018 Oct;109:75-83
pubmed: 30125790
Schizophr Res. 2019 Feb;204:389-396
pubmed: 30154027
JMIR Mhealth Uhealth. 2018 Sep 04;6(9):e10274
pubmed: 30181109
Psychiatry Res. 2018 Nov;269:753-762
pubmed: 30273901
Psychiatry Res. 2018 Dec;270:394-403
pubmed: 30300870
JMIR Ment Health. 2018 Oct 11;5(4):e60
pubmed: 30309837
Epidemiol Psychiatr Sci. 2019 Jun;28(3):278-279
pubmed: 30479243
J Affect Disord. 2019 Mar 1;246:444-451
pubmed: 30599367

Auteurs

Jake Linardon (J)

School of Psychology, Deakin University, Geelong, Victoria, Australia.

Pim Cuijpers (P)

Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Per Carlbring (P)

Department of Psychology, Stockholm University, Stockholm, Sweden.

Mariel Messer (M)

School of Psychology, Deakin University, Geelong, Victoria, Australia.

Matthew Fuller-Tyszkiewicz (M)

School of Psychology, Deakin University, Geelong, Victoria, Australia.
Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria, Australia.

Classifications MeSH