A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content

Wasil, Akash R.; Venturo‐Conerly, Katherine E.; Shingleton, Rebecca; Weisz, John R.

doi:10.1016/j.brat.2019.103498

Cited by 116 publications

(115 citation statements)

References 54 publications

(72 reference statements)

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“…Psychoeducation, behavioral activation, and cognitive restructuring were the most common treatment elements, while expressive writing, mindfulness, and emotion-focused interventions were the least common. Taken together, our results suggest that iCBTs that have been tested in the context of RCTs are different than popular MH apps, in the sense that they are more likely to have evidence-based components, but they are predominately not available to the public (Wasil et al, 2019).…”

Section: Discussionmentioning

confidence: 80%

“…Secondly, we wanted to identify which treatment components were frequently utilized. We benchmarked these frequencies against a recent review of popular MH apps (Wasil et al, 2019). Psychoeducation, behavioral activation, and cognitive restructuring were the most common treatment elements, while expressive writing, mindfulness, and emotion-focused interventions were the least common.…”

Section: Discussionmentioning

confidence: 99%

“…As would be expected, given their central role in cognitive-behavioral therapy, psychoeducation, behavioral activation, and cognitive restructuring were the most frequently utilized components in iCBTs. Of note, these treatment components are not well-represented in MH apps, which appear to prioritize mindfulness and meditation (Wasil et al, 2019). Several factors can explain this discrepancy.…”

Section: Discussionmentioning

confidence: 99%

“…When comparing the iCBT packages we identified with the popular MH apps Wasil et al (2019) identified, several patterns emerged (See Table 2). The iCBTs were more likely to contain psychoeducation, cognitive restructuring, behavioral activation, interpersonal communication, problem solving, and anxiety content.…”

Section: Benchmarking Analysismentioning

confidence: 99%

“…Although the use of the internet to reduce the burden of untreated depression appears promising, there are several reasons to be cautious about its application. For example, a recent review of publicly available mental health apps (MH apps) found that certain evidence-based treatment elements were rarely included in MH apps (Wasil et al, 2019). Here, MH apps were defined as any telephone applications, one can download from a commercial marketplace like the Apple App store or Google Play store.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Availability of internet-based cognitive behavioral therapies (iCBTs) for depression: A systematic review

Buss¹,

Lorenzo‐Luaces²,

Banks³

et al. 2020

Preprint

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We examined the availability and components of internet-based cognitive-behavioral therapies (iCBTs) for depression tested in randomized-controlled trials (RCTs). Our search yielded 59 studies that used 30 unique iCBTs. Of these, only seven (23%) were completely available to the public, more than half were not publicly available (57%), and the remaining 20% were available but had some restriction (e.g., geographical). When comparing iCBTs to commercially available smartphone apps, we found that iCBTs were more likely to contain psychoeducation, cognitive restructuring, behavioral activation, problem-solving, interpersonal communication, and anxiety content, and less likely to contain mindfulness. iCBTs contain evidence-based content but few are available to the public. Extending beyond efficacy, attention should be paid to the dissemination of iCBTs.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Benchmarking Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Availability of internet-based cognitive behavioral therapies (iCBTs) for depression: A systematic review

Buss¹,

Lorenzo‐Luaces²,

Banks³

et al. 2020

Preprint

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Management of Depression in Adults

Simon,

Moise,

Mohr

2024

JAMA

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ImportanceApproximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women.ObservationsMajor depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm, suspected bipolar disorder, psychotic symptoms, substance use, and co-occurring anxiety disorder. First-line treatments include specific psychotherapies and antidepressant medications. A network meta-analysis of randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving therapy, interpersonal therapy, brief psychodynamic therapy, and mindfulness-based psychotherapy all had at least medium-sized effects in symptom improvement over usual care without psychotherapy (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 [95% CI, 0.52-0.95]). A network meta-analysis of randomized clinical trials reported 21 antidepressant medications all had small- to medium-sized effects in symptom improvement over placebo (SMD ranging from 0.23 [95% CI, 0.19-0.28] for fluoxetine to 0.48 [95% CI, 0.41-0.55] for amitriptyline). Psychotherapy combined with antidepressant medication may be preferred, especially for more severe or chronic depression. A network meta-analysis of randomized clinical trials reported greater symptom improvement with combined treatment than with psychotherapy alone (SMD, 0.30 [95% CI, 0.14-0.45]) or medication alone (SMD, 0.33 [95% CI, 0.20-0.47]). When initial antidepressant medication is not effective, second-line medication treatment includes changing antidepressant medication, adding a second antidepressant, or augmenting with a nonantidepressant medication, which have approximately equal likelihood of success based on a network meta-analysis. Collaborative care programs, including systematic follow-up and outcome assessment, improve treatment effectiveness, with 1 meta-analysis reporting significantly greater symptom improvement compared with usual care (SMD, 0.42 [95% CI, 0.23-0.61]).Conclusions and RelevanceEffective first-line depression treatments include specific forms of psychotherapy and more than 20 antidepressant medications. Close monitoring significantly improves the likelihood of treatment success.

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Efficacy of a Mobile App-Based Intervention for Young Adults With Anxiety Disorders

Bress,

Falk,

Schier

et al. 2024

JAMA Netw Open

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ImportanceAnxiety disorders are prevalent and undertreated among young adults. Digital mental health interventions for anxiety are promising but limited by a narrow range of therapeutic components and low user engagement.ObjectiveTo investigate the efficacy of and engagement with Maya, a scalable, self-guided, comprehensive mobile cognitive behavioral therapy (CBT) intervention with embedded engagement features, comparing the effects of 3 incentive conditions.Design, Setting, and ParticipantsThis randomized clinical trial recruited young adults aged 18 to 25 years with anxiety disorders through online advertisements and outpatient psychiatry clinics at Weill Cornell Medicine. Enrollment was between June 16, 2021, and November 11, 2022. Data analysis was performed from December 21, 2022, to June 14, 2024.InterventionParticipants received a 6-week program of the intervention and were randomized to 1 of 3 different text message–based incentive conditions (gain-framed, loss-framed, or gain–social support).Main Outcomes and MeasuresThe primary outcome was change in anxious symptoms from baseline to end of treatment, as measured by the Hamilton Anxiety Rating Scale (HAM-A). The Anxiety Sensitivity Index and the Leibowitz Social Anxiety Scale scores were secondary measures.ResultsThe sample consisted of 59 participants (mean [SD] age, 23.1 [1.9] years; 46 [78%] female; 22 [37%] Asian, 3 [5%] Black, 5 [8%] Hispanic or Latino, 1 [2%] American Indian or Alaska Native, 25 [42%] White, and 6 [10%] &gt;1 race; 32 [54%] college-educated and 12 [20%] graduate or professional school-educated; mean [SD] baseline HAM-A score, 15.0 [6.5]). Anxiety, measured by HAM-A, decreased across conditions from baseline to end of the intervention (mean difference, −5.64; 95% CI, −7.23 to −4.05), and symptomatic improvement was maintained at the week 12 follow-up (baseline to follow-up mean difference, −5.67; 95% CI, −7.29 to −4.04). However, there was no evidence that change in anxiety differed by incentive condition (loss-framed vs gain–social support mean difference, −1.40; 95% CI, −4.72 to 1.93; gain-framed vs gain–social support mean difference, 1.38; 95% CI, −1.19 to 3.96). Secondary anxiety measures (Anxiety Sensitivity Index and Liebowitz Social Anxiety Scale scores) showed a similar pattern of improvement, with no evidence of differences between incentive conditions. Participants completed most of the 12 sessions (mean [SD], 10.8 [2.1]; 95% CI, 10.3-11.4), and User Mobile Application Rating Scale app quality ratings exceeded the published threshold for acceptability at all study visits. There was no evidence that either session completion or app quality ratings differed by incentive condition.Conclusions and RelevanceIn this randomized clinical trial of an app-based intervention for anxiety, the primary hypothesis that improvement in anxiety would be greatest in the condition using gain of points plus social incentives was not supported; however, the results suggest that a CBT application incorporating a full suite of CBT skills and embedded user engagement features was efficacious in improving symptoms in young adults with anxiety disorders. Given these findings, digital interventions represent a promising step toward wider dissemination of high-quality, evidence-based interventions.Trial RegistrationClinicalTrials.gov Identifier: NCT05130281

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A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content

Cited by 116 publications

References 54 publications

Availability of internet-based cognitive behavioral therapies (iCBTs) for depression: A systematic review

Availability of internet-based cognitive behavioral therapies (iCBTs) for depression: A systematic review

Management of Depression in Adults

Efficacy of a Mobile App-Based Intervention for Young Adults With Anxiety Disorders

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