Sensory and cognitive mechanisms allow stimuli to be perceived with properties relating to sight, sound, touch, etc, and ensure, for example, that visual properties are perceived as visual experiences, rather than sounds, tastes, smells, etc. Theories of normal development can be informed by cases where this modularity breaks down, in a condition known as synaesthesia. Conventional wisdom has held that this occurs extremely rarely (0.05% of births) and affects women more than men. Here we present the first test of synaesthesia prevalence with sampling that does not rely on self-referral, and which uses objective tests to establish genuineness. We show that (a) the prevalence of synaesthesia is 88 times higher than previously assumed, (b) the most common variant is coloured days, (c) the most studied variant (grapheme - colour synaesthesia)—previously believed most common—is prevalent at 1%, and (d) there is no strong asymmetry in the distribution of synaesthesia across the sexes. Hence, we suggest that female biases reported earlier likely arose from (or were exaggerated by) sex differences in self-disclosure.

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SMS-based technology can offer a time-, labor-, and cost-efficient strategy for encouraging engagement with psychiatric outpatient services. In England alone, a reduction of 25% to 28% in missed outpatient clinic appointments would translate to national cost savings of more than £150 million, or $245 million, per year, and likely have clinical benefits as well.

Background Depression and anxiety symptoms are common among university students, but many do not receive treatment. This is often because of lack of availability, reluctance to seek help, and not meeting the diagnostic criteria required to access services. Internet-based interventions, including smartphone apps, can overcome these issues. However, a large number of apps are available, each with little evidence of their effectiveness. Objective This study aims to evaluate for the first time the effectiveness of a self-guided mobile app, Feel Stress Free, for the treatment of depression and anxiety symptoms in students. Methods A web-based randomized controlled trial compared a cognitive behavioral therapy (CBT)–based mobile app Feel Stress Free with a wait-list control. University students self-identified as experiencing symptoms of anxiety or depression and were randomized to 6 weeks of intervention (n=84) or control (n=84), unblinded. The app is self-guided and incorporates behavioral relaxation activities, mood tracking and thought challenging, and minigames. Participants completed the Hospital Anxiety and Depression Scale online at baseline and every fortnight. Results At week 6, the primary end point, there was evidence that the Feel Stress Free app reduced depression symptoms (mean difference −1.56; 95% CI −2.67 to −0.44; P=.006) but only very weak evidence that it reduced anxiety symptoms (mean difference −1.36; 95% CI −2.93 to 0.21; P=.09). At week 4, there was evidence to support the effectiveness of the intervention for anxiety symptoms (mean difference −1.94; 95% CI −3.11 to −0.77; P=.001) and, though weaker, depression symptoms (mean difference −1.08; 95% CI −2.12 to −0.04; P=.04). At week 6, 83% (34/41) of participants indicated that they were using the app weekly or more frequently. Conclusions The Feel Stress Free app is a promising mobile intervention for treating symptoms of anxiety and depression in students and overcomes many of the barriers to traditional CBT. Further research is needed to establish its effectiveness at and beyond 6 weeks. Trial Registration ClinicalTrials.gov NCT03032952; https://clinicaltrials.gov/ct2/show/NCT03032952

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