App-supported smartphone interventions effective for common mental health problems

Mental health smartphone applications (apps) help improve a range of outcomes, including depressive and generalized anxiety symptoms and stress levels, with small-to-moderate effect sizes, according to a meta-analysis.

Researchers searched multiple online databases for randomized controlled trials evaluating the efficacy of smartphone interventions designed to improve mental health or general well‐being in comparison with control conditions (eg, waitlist, assessment only, treatment as usual, informational and educational resources, or attention/placebo controls).

The meta-analysis included 66 trials with 77 smartphone intervention conditions. Most of the apps tested were based on cognitive and/or behavioural principles (n=35) and/or acceptance‐ or mindfulness‐based principles (n=38).

Pooled data revealed that app-supported smartphone interventions performed significantly better than control conditions in terms of improving the following: 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). Effect sizes ranged from small to moderate and proved to be robust to common biasing factors in trials, including the type of control condition, trial risk of bias rating and publication bias.

However, the smartphone interventions conferred no significant benefit for panic symptoms (g=–0.05; n=3), post‐traumatic stress symptoms (g=0.18; n=4) and negative affect (g=–0.08; n=5).

Cognitive behaviour therapy‐based apps, used with professional guidance and reminders to engage, produced larger effects on multiple outcomes. More importantly, they exerted effects comparable to that obtained with active interventions (eg, face‐to‐face and computerized treatment), although the number of studies was low (n≤13).

The researchers pointed out that although mental health apps are not intended to replace professional clinical services, such apps have the potential to serve as a cost‐effective, easily accessible and low-intensity intervention for the millions of people worldwide who cannot receive standard psychological treatment.