Background: The coronavirus pandemic has resulted in increased demands for online mental health (MH) services as social distancing measures made access to MH care increasingly difficult. Before the pandemic, many mobile app-based interventions had shown their effectiveness on MH-related measures. However, effectiveness under pandemic conditions has not been systematically reviewed.
Methods: Controlled trials assessing the effects of app-based interventions on MH-related measures were identified from PsycINFO, Pubmed, EMBASE, and Web of Science using PRISMA guidelines. Studies were excluded if they were: conducted before 2020; cross-sectional only; targeting individuals with non-psychiatric diagnoses; study protocols; conference proceedings; exclusively qualitative; or non-English.
Results: Ten studies were reviewed. The apps were based on various therapeutic orientations: cognitive behavioral therapy, mindfulness, positive psychology, motivational interviewing, dialectical behavior therapy, and behavioral activation. Eight studies had no human involvement besides the users. Six sent daily reminders to participants. The study interval (7-112 days) varied across studies. None reported the mean time of actual app use among users. Participants were predominantly female and white. Target populations differed across studies: healthcare workers, adolescents, college students, and pregnant women. Outcomes showing significant improvement through app-based interventions were depression, anxiety, stress, self-esteem, insomnia, quality of relationships, decisiveness, self-compassion, emotional regulation, and sense of well-being. Dropout rates in intervention groups varied (3.7%-58.4%).
Conclusions: In the pandemic, app-based mobile interventions have shown the potential to improve various MH-related outcomes. No app has shown efficacy in improving suicidality or self-injurious behavior. Future research needs to specify which components of an app promote or hinder its effectiveness and engagement. Collecting passive user data from an app may help examine the dose-effect relationship. To address the multiple comparisons issue, more strict statistical cut-offs are warranted.
Live Zoom Session – March 9th
Joo-Young Lee, MD, MS, Elizabeth Stettenbauer, MA, Marin Waddington, Dharma Cortes, PhD, Todd G. Reid, ScD, MPH, MBA, Nicholas Carson, MD
Nicholas Carson, MD