The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials

Jake Linardon, Pim Cuijpers, Per Carlbring, Mariel Messer, Matthew Fuller-Tyszkiewicz

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=–0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=–0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.

Original languageEnglish
Pages (from-to)325-336
Number of pages12
JournalWorld Psychiatry
Volume18
Issue number3
Early online date9 Sep 2019
DOIs
Publication statusPublished - 1 Oct 2019

Fingerprint

Meta-Analysis
Mental Health
Randomized Controlled Trials
Anxiety
Panic
Cognitive Therapy
Psychiatry
Smartphone
Quality of Life
Psychology
Costs and Cost Analysis

Keywords

  • anxiety
  • App-supported smartphone interventions
  • depression
  • general psychiatric distress
  • mental health problems
  • positive affect
  • psychological treatments

Cite this

Linardon, Jake ; Cuijpers, Pim ; Carlbring, Per ; Messer, Mariel ; Fuller-Tyszkiewicz, Matthew. / The efficacy of app-supported smartphone interventions for mental health problems : a meta-analysis of randomized controlled trials. In: World Psychiatry. 2019 ; Vol. 18, No. 3. pp. 325-336.
@article{ec2d3a7340c740519090352b1b9b64ee,
title = "The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials",
abstract = "Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=–0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=–0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.",
keywords = "anxiety, App-supported smartphone interventions, depression, general psychiatric distress, mental health problems, positive affect, psychological treatments",
author = "Jake Linardon and Pim Cuijpers and Per Carlbring and Mariel Messer and Matthew Fuller-Tyszkiewicz",
year = "2019",
month = "10",
day = "1",
doi = "10.1002/wps.20673",
language = "English",
volume = "18",
pages = "325--336",
journal = "World Psychiatry",
issn = "1723-8617",
publisher = "Masson SpA",
number = "3",

}

The efficacy of app-supported smartphone interventions for mental health problems : a meta-analysis of randomized controlled trials. / Linardon, Jake; Cuijpers, Pim; Carlbring, Per; Messer, Mariel; Fuller-Tyszkiewicz, Matthew.

In: World Psychiatry, Vol. 18, No. 3, 01.10.2019, p. 325-336.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - The efficacy of app-supported smartphone interventions for mental health problems

T2 - a meta-analysis of randomized controlled trials

AU - Linardon, Jake

AU - Cuijpers, Pim

AU - Carlbring, Per

AU - Messer, Mariel

AU - Fuller-Tyszkiewicz, Matthew

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=–0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=–0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.

AB - Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=–0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=–0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.

KW - anxiety

KW - App-supported smartphone interventions

KW - depression

KW - general psychiatric distress

KW - mental health problems

KW - positive affect

KW - psychological treatments

UR - http://www.scopus.com/inward/record.url?scp=85068344689&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068344689&partnerID=8YFLogxK

U2 - 10.1002/wps.20673

DO - 10.1002/wps.20673

M3 - Article

VL - 18

SP - 325

EP - 336

JO - World Psychiatry

JF - World Psychiatry

SN - 1723-8617

IS - 3

ER -