The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials
The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials
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DOI：
10.1002/wps.20472
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发表时间：
2017-10-01
期刊：
影响因子：
73.3
通讯作者：
Sarris, Jerome
中科院分区：
文献类型：
--
作者：
Firth, Joseph;Torous, John;Sarris, Jerome
智能手机技术的快速发展和采用为在人口规模上提供心理健康干预提供了新的机会。尽管有多部门的投资沿着大规模的广告和对普通人群的可用性，但支持使用智能手机应用程序治疗抑郁症的证据尚未进行经验评估。因此，我们对抑郁症状的智能手机应用程序进行了首次荟萃分析。2017年5月的一项电子数据库检索确定了22个智能手机应用程序的18项合格随机对照试验，结果数据来自3，414名参与者。与对照组相比，智能手机应用程序显著降低了抑郁症状（g=0.38，95%CI：0.24-0.52，p< 0.001），没有证据表明存在发表偏倚。与非活动对照相比，智能手机干预具有中度积极影响（g=0.56，95%CI：0.38-0.74），但与活动对照条件相比，影响较小（g=0.22，95%CI：0.10-0.33）。仅智能手机干预的影响大于智能手机组件沿着其他人类/计算机方面的干预，尽管差异不具有统计学显著性。认知训练应用程序的研究对抑郁结果的影响显著小于专注于心理健康的应用程序的影响（p=0.004）。使用情绪监测软件，或基于认知行为疗法的干预措施，或包含正念训练方面的应用程序，并没有显著影响研究效果。总的来说，这些结果表明，智能手机设备是一种很有前途的抑郁症自我管理工具。未来的研究应旨在确定这些技术的哪些方面产生了有益的影响，以及对哪些人群产生了有益的影响。
The rapid advances and adoption of smartphone technology presents a novel opportunity for delivering mental health interventions on a population scale. Despite multi-sector investment along with wide-scale advertising and availability to the general population, the evidence supporting the use of smartphone apps in the treatment of depression has not been empirically evaluated. Thus, we conducted the first meta-analysis of smartphone apps for depressive symptoms. An electronic database search in May 2017 identified 18 eligible randomized controlled trials of 22 smartphone apps, with outcome data from 3,414 participants. Depressive symptoms were reduced significantly more from smartphone apps than control conditions (g=0.38, 95% CI: 0.24-0.52, p< 0.001), with no evidence of publication bias. Smartphone interventions had a moderate positive effect in comparison to inactive controls (g=0.56, 95% CI: 0.38-0.74), but only a small effect in comparison to active control conditions (g=0.22, 95% CI: 0.10-0.33). Effects from smartphone-only interventions were greater than from interventions which incorporated other human/ computerized aspects along the smartphone component, although the difference was not statistically significant. The studies of cognitive training apps had a significantly smaller effect size on depression outcomes (p=0.004) than those of apps focusing on mental health. The use of mood monitoring softwares, or interventions based on cognitive behavioral therapy, or apps incorporating aspects of mindfulness training, did not affect significantly study effect sizes. Overall, these results indicate that smartphone devices are a promising self-management tool for depression. Future research should aim to distil which aspects of these technologies produce beneficial effects, and for which populations.