There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.
Abstract
Despite the emergence of curated app libraries for mental health apps, personal searches
by consumers remain a common method for discovering apps. App store descriptions therefore
represent a key channel to inform consumer choice. This study examined the claims
invoked through these app store descriptions, the extent to which scientific language
is used to support such claims, and the corresponding evidence in the literature.
Google Play and iTunes were searched for apps related to depression, self-harm, substance
use, anxiety, and schizophrenia. The descriptions of the top-ranking, consumer-focused
apps were coded to identify claims of acceptability and effectiveness, and forms of
supporting statement. For apps which invoked ostensibly scientific principles, a literature
search was conducted to assess their credibility. Seventy-three apps were coded, and
the majority (64%) claimed effectiveness at diagnosing a mental health condition,
or improving symptoms, mood or self-management. Scientific language was most frequently
used to support these effectiveness claims (44%), although this included techniques
not validated by literature searches (8/24 = 33%). Two apps described low-quality,
primary evidence to support the use of the app. Only one app included a citation to
published literature. A minority of apps (14%) described design or development involving
lived experience, and none referenced certification or accreditation processes such
as app libraries. Scientific language was the most frequently invoked form of support
for use of mental health apps; however, high-quality evidence is not commonly described.
Improved knowledge translation strategies may improve the adoption of other strategies,
such as certification or lived experience co-design.
The rapid advances and adoption of smartphone technology presents a novel opportunity for delivering mental health interventions on a population scale. Despite multi-sector investment along with wide-scale advertising and availability to the general population, the evidence supporting the use of smartphone apps in the treatment of depression has not been empirically evaluated. Thus, we conducted the first meta-analysis of smartphone apps for depressive symptoms. An electronic database search in May 2017 identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants. Depressive symptoms were reduced significantly more from smartphone apps than control conditions (g=0.38, 95% CI: 0.24-0.52, p<0.001), with no evidence of publication bias. Smartphone interventions had a moderate positive effect in comparison to inactive controls (g=0.56, 95% CI: 0.38-0.74), but only a small effect in comparison to active control conditions (g=0.22, 95% CI: 0.10-0.33). Effects from smartphone-only interventions were greater than from interventions which incorporated other human/computerized aspects along the smartphone component, although the difference was not statistically significant. The studies of cognitive training apps had a significantly smaller effect size on depression outcomes (p=0.004) than those of apps focusing on mental health. The use of mood monitoring softwares, or interventions based on cognitive behavioral therapy, or apps incorporating aspects of mindfulness training, did not affect significantly study effect sizes. Overall, these results indicate that smartphone devices are a promising self-management tool for depression. Future research should aim to distil which aspects of these technologies produce beneficial effects, and for which populations.
Various psychological interventions are effective for reducing symptoms of anxiety when used alone, or as an adjunct to anti-anxiety medications. Recent studies have further indicated that smartphone-supported psychological interventions may also reduce anxiety, although the role of mobile devices in the treatment and management of anxiety disorders has yet to be established.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.