scholarly journals Self-guided cognitive behavioral therapy apps: Can they help? Systematic assessment of features, functionality, and congruence with evidence (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Konstadina Griva ◽  
Paola Dazzan ◽  
Carmine Maria Pariante ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Data Security ◽  
Suicide Risk ◽  
Behavioral Therapy ◽  
Cognitive Restructuring ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Systematic Assessment ◽  
Health Apps

BACKGROUND Mental health disorders affect one in ten people globally, of which around 300 million are affected by depression. At least half of affected people remain untreated. Cognitive behavioral therapy (CBT) is an effective treatment but access to specialized providers, habitually challenging, has worsened with COVID-19. Internet-based CBT (iCBT) is effective and a feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression but accessing the right app might be cumbersome given the large number and wide variety of apps offered by public app marketplaces. OBJECTIVE To systematically assess features, functionality, data security and congruence with evidence of self-guided CBT-based apps available in major app stores, suitable for users suffering from depression. METHODS A systematic assessment of self-guided CBT-based apps available in Google Play and Apple’s App Store was conducted. Apps launched or updated since August 2018 were identified through a systematic search in 42matters using CBT-related terms. Apps meeting inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, comprising apps’ general characteristics, CBT-related features, including six evidence-based CBT techniques as informed by a CBT manual, CBT competences framework and a literature review of iCBT clinical trial protocols (psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety), and technical aspects and quality assurance. Results were reported as a narrative review, using descriptive statistics. RESULTS The initial search yielded 3006 apps, of which 98 apps met inclusion criteria and were systematically assessed. There were 20 wellbeing apps, 65 mental health apps and 13 depression apps. Twenty-eight apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 77/98 apps. Only a third of apps offered suicide- risk management resources while less than 20% of apps offered COVID-19-related information. Most apps included a privacy policy, but only a third of apps presented it before account creation. Eighty percent of privacy policies stated sharing data with third party service providers. Half of app development teams included academic institutions or healthcare providers. CONCLUSIONS Only few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in the health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient-centered and enhance users’ data security. CLINICALTRIAL NA

Mental health apps education on depression: Systematic assessment (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Lorainne Tudor Car ◽  
Jimmy Lee ◽  
Konstadina Griva ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Guidelines ◽  
Help Seeking ◽  
Support Network ◽  
Evidence Based ◽  
Educational Content ◽  
Systematic Assessment ◽  
Android Apps ◽  
Symptoms Of Depression ◽  
Health Apps

BACKGROUND Suboptimal understanding of depression and mental health disorders by the general population is an important contributor to the wide treatment gap in depression. Mental health literacy encompasses knowledge and beliefs about mental disorders and supports their recognition, management, and prevention. Besides knowledge improvement, psychoeducational interventions reduce symptoms of depression, enhance help-seeking behavior, and decrease stigma. Mental health apps often offer educational content, but the trustworthiness of included information is unclear OBJECTIVE To systematically evaluate adherence to depression clinical guidelines of the information offered by mental health apps available in major commercial app stores. METHODS A systematic assessment of the educational content about depression in apps available in Google Play and Apple’s App Store was conducted in July 2020. A systematic search for apps published or updated since January 2019 was performed using 42matters. Apps meeting inclusion criteria were downloaded and assessed using an iPhone 7 (iOS 14.0.1) and a Sony XPERIA XZs (Android 8.0.0) smartphones. The 156 questions assessment checklist comprised general characteristics of apps, appraisal of educational content and its adherence to evidence-based clinical guidelines, and technical aspects and quality assurance. Results were tabulated and reported as a narrative review, using descriptive statistics. RESULTS The app search retrieved 2,218 apps of which 58 were included in the analysis (29 Android apps and 29 iOS apps). Thirty-seven apps (64%) offered educational content within a more comprehensive depression or mental health management app. Twelve apps (21%) provided non-evidence-based information. Most apps (51/58, 88%) included up to 20/38 educational topics assessed. Common educational topics were listing symptoms of depression (52/58, 90%) and available treatments (48/58, 83%), particularly psychotherapy. Depression-associated stigma was mentioned by 38% of apps, while suicide risk was mentioned by 71% of apps, generally as one item in a list of symptoms. Forty-four (76%) apps highlighted the importance of help-seeking, and 50% of apps emphasized the importance of involving the user’s support network. Thirty apps (52%) referenced their content and ten apps (17%) included advertisements. CONCLUSIONS Information in mental health and depression apps is often brief and incomplete. One in five apps provided non-evidence-based information. Given the unmet needs and stigma associated with the disease, it is imperative that apps seize the opportunity to offer quality, evidence-based education and/or point the users to relevant resources. A multi-stakeholder consensus on a more stringent development and publication process for mental health apps is imperative.

scholarly journals Apps With Maps—Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores (Preprint)

2019 ◽  
Author(s):  
Jamie M Marshall ◽  
Debra A Dunstan ◽  
Warren Bartik
Keyword(s):  
Mental Health ◽  
Dialectical Behavior Therapy ◽  
Behavioral Therapy ◽  
Therapeutic Interventions ◽  
Anxiety And Depression ◽  
Future Research ◽  
Evidence Based ◽  
Health Apps ◽  
App Store ◽  
Published Evidence

BACKGROUND Mobile mental health apps have become ubiquitous tools to assist people in managing symptoms of anxiety and depression. However, due to the lack of research and expert input that has accompanied the development of most apps, concerns have been raised by clinicians, researchers, and government authorities about their efficacy. OBJECTIVE This review aimed to estimate the proportion of mental health apps offering comprehensive therapeutic treatments for anxiety and/or depression available in the app stores that have been developed using evidence-based frameworks. It also aimed to estimate the proportions of specific frameworks being used in an effort to understand which frameworks are having the most influence on app developers in this area. METHODS A systematic review of the Apple App Store and Google Play store was performed to identify apps offering comprehensive therapeutic interventions that targeted anxiety and/or depression. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was adapted to guide this approach. RESULTS Of the 293 apps shortlisted as offering a therapeutic treatment for anxiety and/or depression, 162 (55.3%) mentioned an evidence-based framework in their app store descriptions. Of the 293 apps, 88 (30.0%) claimed to use cognitive behavioral therapy techniques, 46 (15.7%) claimed to use mindfulness, 27 (9.2%) claimed to use positive psychology, 10 (3.4%) claimed to use dialectical behavior therapy, 5 (1.7%) claimed to use acceptance and commitment therapy, and 20 (6.8%) claimed to use other techniques. Of the 162 apps that claimed to use a theoretical framework, only 10 (6.2%) had published evidence for their efficacy. CONCLUSIONS The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users. Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps.

scholarly journals Apps With Maps—Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores

10.2196/16525 ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. e16525 ◽  
Author(s):  
Jamie M Marshall ◽  
Debra A Dunstan ◽  
Warren Bartik
Keyword(s):  
Mental Health ◽  
Dialectical Behavior Therapy ◽  
Behavioral Therapy ◽  
Therapeutic Interventions ◽  
Anxiety And Depression ◽  
Future Research ◽  
Evidence Based ◽  
Health Apps ◽  
App Store ◽  
Published Evidence

Background Mobile mental health apps have become ubiquitous tools to assist people in managing symptoms of anxiety and depression. However, due to the lack of research and expert input that has accompanied the development of most apps, concerns have been raised by clinicians, researchers, and government authorities about their efficacy. Objective This review aimed to estimate the proportion of mental health apps offering comprehensive therapeutic treatments for anxiety and/or depression available in the app stores that have been developed using evidence-based frameworks. It also aimed to estimate the proportions of specific frameworks being used in an effort to understand which frameworks are having the most influence on app developers in this area. Methods A systematic review of the Apple App Store and Google Play store was performed to identify apps offering comprehensive therapeutic interventions that targeted anxiety and/or depression. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was adapted to guide this approach. Results Of the 293 apps shortlisted as offering a therapeutic treatment for anxiety and/or depression, 162 (55.3%) mentioned an evidence-based framework in their app store descriptions. Of the 293 apps, 88 (30.0%) claimed to use cognitive behavioral therapy techniques, 46 (15.7%) claimed to use mindfulness, 27 (9.2%) claimed to use positive psychology, 10 (3.4%) claimed to use dialectical behavior therapy, 5 (1.7%) claimed to use acceptance and commitment therapy, and 20 (6.8%) claimed to use other techniques. Of the 162 apps that claimed to use a theoretical framework, only 10 (6.2%) had published evidence for their efficacy. Conclusions The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users. Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps.

The effects of mobile apps on stress, anxiety, and depression: overview of systematic reviews

2020 ◽  
pp. 1-11
Author(s):  
Fatemeh Khademian ◽  
Azam Aslani ◽  
Peivand Bastani
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Mobile Apps ◽  
Conclusive Evidence ◽  
Anxiety And Depression ◽  
Health Apps ◽  
Acceptance And Commitment ◽  
Overview Of Systematic Reviews

Abstract Objectives Despite a large number of mobile apps in the field of mental health, it is difficult to find a useful and reliable one, mainly due to the fact that the effectiveness of many apps has not been assessed scientifically. The present study aimed to assess the effects of mental health apps on managing the symptoms of stress, anxiety, and depression. Methods A comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Cochrane, and Web of Science databases for the papers published from 2000 to 2019. Studies were included if they reviewed articles or mobile apps for their effectiveness in stress, anxiety, and depression. The reviews that had considered mobile apps or web-based mobile applications as an intervention or part of intervention were included, as well. Results A total of 4,999 peer-reviewed articles were identified, out of which nine systematic reviews met the inclusion criteria. Seven systematic reviews measured depression outcomes, three measured stress, and five systematic reviews measured anxiety symptoms. The applications that used behavior change strategies, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Behavioral Activation, reported significant effects on depression, anxiety, and stress. Conclusion It seems that mental health apps can be promising media for reducing depressive symptoms. This field is an emerging area of mobile health, and further research should be done in future in order to reach conclusive evidence.

Efficacy, effectiveness, and quality of resilience-building mobile health apps for military, veteran and public safety personnel populations: a scoping literature review and app evaluation (Preprint)

2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Mobile Health ◽  
Public Safety ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Public Safety Personnel ◽  
Scoping Literature Review ◽  
Mhealth Apps ◽  
Safety Personnel

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A

scholarly journals Mobile Mental Health Apps in China: Systematic App Store Search (Preprint)

2019 ◽  
Author(s):  
Huifang Yin ◽  
Klaas J Wardenaar ◽  
Yuhao Wang ◽  
Nan Wang ◽  
Wenjin Chen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Mobile Apps ◽  
Psychiatric Patients ◽  
Evidence Based ◽  
Health Apps ◽  
Main Technique ◽  
Stress Relieving ◽  
Mobile Mental Health

BACKGROUND Smartphones have become ubiquitous in China, offering a promising way to deliver mental health interventions; however, little is known about the current use and characteristics of smartphone apps for mental health. OBJECTIVE The purpose of this study was to gain insight into mobile mental health apps available in China as of December 2018. METHODS A systematic search was conducted to identify and evaluate the most downloaded apps from iOS and Android platforms. Apps were categorized according to their main purpose and downloaded to evaluate their content. Each app’s affiliation, cost, target users, information security, and evidence-based nature were evaluated. RESULTS Of the 172 unique apps that were identified, there were 37 apps (21.5%) for psychological counseling, 50 apps (29.1%) for assessment, 12 apps (7.0%) to relieve stress, 24 apps (14.0%) for psychoeducation, and 49 (28.4%) multipurpose apps (ie, a combination of counseling and assessment). Most apps were developed for adults in the general population (166/172, 96.5%), rather than for psychiatric patients. App-based counseling was mostly provided by psychologists, and of the assessed apps, only 40% (70/172) used evidence-based scales to assess mental health problems such as anxiety or depressed mood. Guided meditation was used as the main technique in stress-relieving apps. CONCLUSIONS Many apps contained useful and evidence-based elements, such as good quality information, validated measurements, and useful meditation methods; however, for mobile apps to contribute significantly to mental health care in China, considerable challenges remain, including the need for more patient-focused apps that can actually take on the role of a health care provider. In addition, efficacy studies are needed.

scholarly journals Marketplace and Literature Review of Spanish Language Mental Health Apps

2021 ◽  
Vol 3 ◽  
Author(s):  
Alma Oñate Muñoz ◽  
Erica Camacho ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Phase 1 ◽  
The United States ◽  
Spanish Language ◽  
Inclusion Criteria ◽  
Language Differences ◽  
Health Apps ◽  
App Development ◽  
Published Research

Language differences between patients and providers remains a barrier to accessing health care, especially mental health services. One potential solution to reduce inequities for patients that speak different languages and improve their access to care is through the delivery of healthcare through mobile technology. Given that the Latinx community serves as the largest ethnic minority in the United States, this two-phased review examines Spanish app development, feasibility and efficacy. Phase 1 explored the commercial marketplace for apps available in Spanish, while phase 2 involved a literature review of published research centered around the creation, functions, and usability of these apps using the PubMed and Google Scholar electronic databases. Of the apps available on the database, only 14.5% of them had Spanish operability. The literature search uncovered 629 results, of which 12 research articles that tested or described 10 apps met the inclusion criteria. Of the 10 apps studied in this literature review, only four apps were translated to Spanish. Our study reveals that despite increasing interest in Spanish-language apps to address mental health, the commercial marketplace is not currently meeting the demand.

scholarly journals Acceptance and Expectations of Medical Experts, Students, and Patients Toward Electronic Mental Health Apps: Cross-Sectional Quantitative and Qualitative Survey Study (Preprint)

2019 ◽  
Author(s):  
Gwendolyn Mayer ◽  
Nadine Gronewold ◽  
Simone Alvarez ◽  
Bastian Bruns ◽  
Thomas Hilbel ◽  
...  
Keyword(s):  
Mental Health ◽  
Data Security ◽  
Survey Study ◽  
Professional Experience ◽  
Total Risk ◽  
Multiple Choice Questions ◽  
Future Expectations ◽  
Cross Sectional ◽  
Health Apps ◽  
Qualitative Survey

BACKGROUND The acceptability of electronic mental (e-mental) health apps has already been studied. However, the attitudes of medical experts, students, and patients taking into account their knowledge of and previous experiences with e-mental health apps have not been investigated. OBJECTIVE The aim of this study was to explore the attitudes, expectations, and concerns of medical experts, including physicians, psychotherapists and nursing staff, students of medicine or psychology, and patients toward e-mental health apps when considering their knowledge of and former experiences with e-mental health apps. METHODS This cross-sectional quantitative and qualitative survey was based on a self-developed questionnaire. A total of 269 participants were included (104 experts, 80 students, and 85 patients), and 124 eligible participants answered a paper version and 145 answered an identical online version of the questionnaire. The measures focused on existing knowledge of and experiences with e-mental health apps, followed by a question on whether electronic health development was generally accepted or disliked. Further, we asked about the expectations for an ideal e-mental health app and possible concerns felt by the participants. All items were either presented on a 5-point Likert scale or as multiple-choice questions. Additionally, 4 items were presented as open text fields. RESULTS Although 33.7% (35/104) of the experts, 15.0% (12/80) of the students, and 41.2% (35/85) of the patients knew at least one e-mental health app, few had already tried one (9/104 experts [8.7%], 1/80 students [1.3%], 22/85 patients [25.9%]). There were more advocates than skeptics in each group (advocates: 71/104 experts [68.3%], 50/80 students [62.5%], 46/85 patients [54.1%]; skeptics: 31/104 experts [29.8%], 20/80 students [25.0%], 26/85 patients [30.6%]). The experts, in particular, believed, that e-mental health apps will gain importance in the future (mean 1.08, SD 0.68; 95% CI 0.94-1.21). When asked about potential risks, all groups reported slight concerns regarding data security (mean 0.85, SD 1.09; 95% CI 0.72-0.98). Patient age was associated with several attitudes toward e-mental health apps (future expectations: r=–0.31, <italic>P</italic>=.005; total risk score: r=0.22, <italic>P</italic>=.05). Attitudes toward e-mental health apps correlated negatively with the professional experience of the experts (r<sub>s</sub>(94)=–0.23, <italic>P</italic>=.03). CONCLUSIONS As opposed to patients, medical experts and students lack knowledge of and experience with e-mental health apps. If present, the experiences were assessed positively. However, experts show a more open-minded attitude with less fear of risks. Although some risks were perceived regarding data security, the attitudes and expectations of all groups were rather positive. Older patients and medical experts with long professional experience tend to express more skepticism. CLINICALTRIAL German Clinical Trials Register DRKS00013095; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&amp;TRIAL_ID=DRKS00013095

scholarly journals Current Practices of Suicide Risk Management Protocols in Research

Crisis ◽  
2010 ◽  
Vol 31 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Steven Vannoy ◽  
Ursula Whiteside ◽  
Jürgen Unützer
Keyword(s):  
Mental Health ◽  
United States ◽  
Risk Management ◽  
Suicide Risk ◽  
Qualitative Methodology ◽  
Descriptive Analysis ◽  
The United States ◽  
Convenience Sample ◽  
Wide Range ◽  
The Impact

Background: Participant safety is an important concern in mental-health-oriented research. Investigators conducting studies in the United States that include potentially suicidal individuals are often required to develop written suicide risk management (SRM) protocols. But little is known about these protocols. It is possible that such protocols could serve as templates for suicide risk management in clinical settings. Aims: To elucidate common (best) practices from mental health intervention researchers. Methods: We conducted a systematic descriptive analysis of written SRM protocols. A convenience sample of studies funded by the United States’ National Institute of Mental Health in 2005 were scanned to discover projects in which investigators were likely to identify and take responsibility for suicide risk in their participant pool. Qualitative methodology was used to create a checklist of tasks perceived to be operationally significant for insuring the safety of suicidal participants. The checklist was applied to all protocols to determine the variability of patient safety tasks across protocols. Results: We identified 45 candidate studies, whereof 38 investigators were contacted, resulting in the review of 21 SRM protocols. Three main categories emerged: overview, entry/exit, and process. Overall, 19 specific tasks were identified. Task frequency varied from 7% to 95% across protocols. Conclusions: The SRM checklist provides a framework for comparing the content of SRM protocols. This checklist may assist in developing SRM protocols in a wide range of settings. Developing guidelines and standard methodologies is an important step to further development of suicide prevention strategies. More research is necessary to determine the impact of SRM protocols on participant safety.

Sign in / Sign up

Export Citation Format

Share Document