Smartphones for self-managing depression: Time for a reality check
Helping people with depression manage their care is among the most promising uses for smartphones and health apps though, to date at least, the possibility has raised more questions than definitive answers.
But a new analysis that began with 1,517 records screened down to 18 unique randomized clinical trials with patients between the mean ages of 18 and 59 years old across 22 distinct mental health interventions delivered by smartphone can at least begin to answer some of the pressing issues.
Chief among those: Can smartphones really be used to help treat depressive patients? Or does the hype outweigh the hope?
That all depends. Let’s start with the hope.
“The nature of smartphone interventions does appear to position them as an ideal self-management tool for those with less severe levels of depression,” the researchers wrote in a report in World Psychiatry, the journal of the World Psychiatric Association. “The observed effects indicate that these interventions are well-placed for delivering low-intensity treatment within a stepped-care approach, or even prevention of mild-to-moderate depression among the millions of people affected by subclinical symptoms.”
That means that smartphone apps can help people with milder symptoms, according to John Tourous, MD, co-director of the digital psychiatry program at Beth Israel Deaconess Medical Center and one of the study’s authors.
“One interesting finding is that apps appeared most effective when used without clinician support, suggesting potential as tools for self management,” Tourous added.
Researchers explained that interventions delivered strictly via smartphone, in fact, had a more significant impact than those including other human or computerized pieces. What’s more, human feedback in certain instances even decreased effectiveness.
That may be a result of individuals who participate in app studies as well as the nature of tools designed to be more comprehensive because they’re designed to be self-contained.
And then there’s the hype. The authors are clear that the meta-analysis is not the final word on smartphones as depression tools.
“We need to begin to gather data on cost-effectiveness to learn if the benefit of these apps can be realized in the real world,” Tourous said. “Digital mental health is maturing to a point where we want to be asking more than can it work now?”
Instead, it’s time to tackle the real questions about effectiveness: Do smartphones actually work for treating depression?
Adequately answering that will require more research, of course, but the findings do point to reason for hope amid all the hype, at least for those people with mild symptoms.