Digital Health Interventions in Prevention, Relapse, and Therapy of Mild and Moderate Depression: Scoping Review (Preprint)

Abstract

BACKGROUND Depression is a major cause for disability worldwide and digital health interventions are expected to be a more augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need of mapping the technological landscape, as well as its benefits for users. OBJECTIVE The purpose of this scoping review was to give an overview of the used DHI for depression. The main goal of this review was then to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS A scoping review was conducted to provide a comprehensive overview in the field of digital health interventions for the treatment of depression. PubMed, Psyndex and the Cochrane Library were searched by two independent researchers in October 2020 to identify relevant publications of the last ten years and were examined due to inclusion and exclusion criteria. For conducting the systematic review, ‘Rayyan’, a free web-tool, was used. RESULTS In total, 65 studies were included in the qualitative synthesis. After categorizing the field of application in prevention, early detection, therapy and relapse prevention, the search showed dominant numbers of studies in the field of therapy (N= 52). There was only one study for prevention, five studies for early detection and seven studies for relapse prevention. The most dominant therapy approaches were cognitive behavior therapy, acceptance and commitment therapy and problem-solving therapy. Most of the studies revealed significant effects of digital health interventions when cognitive behavior therapy applied. Cognitive behavior therapy as the most dominant form was often provided by web-based systems. Combined approaches consisting of web-based and smartphone-based approaches are constantly rising. CONCLUSIONS Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most interventions can be beneficial to achieve a better depression treatment, it can be hindering in determining which approaches are suitable. Cognitive behavior therapy that has been realized with digital health interventions has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

Digitale Gesundheitsinterventionen entwickeln, evaluieren und implementieren (Teil I) – Diskussionspapier der Arbeitsgruppe Digital Health des Deutschen Netzwerk Versorgungsforschung (DNVF)

“…Diese und weitere Herausforderungen bei der Evaluation 6 und Evidenzgenerierung 7 spiegeln sich in den Ergebnissen verschiedener Übersichtsarbeiten wider, die auf eine eingeschränkte bis moderate Evidenz hinweisen 8 9 . Dies bedeutet jedoch nicht, dass keine methodisch hochwertigen Studien durchgeführt wurden oder es keine Wirksamkeitsnachweise gibt 10 .…”