The Use and Effectiveness of Mobile Apps for Depression: Results From a Fully Remote Clinical Trial.
The Use and Effectiveness of Mobile Apps for Depression: Results From a Fully Remote Clinical Trial.
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DOI：
10.2196/jmir.6482
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发表时间：
2016-12-20
影响因子：
7.4
通讯作者：
Anguera JA
中科院分区：
文献类型：
--
作者：
Arean PA;Hallgren KA;Jordan JT;Gazzaley A;Atkins DC;Heagerty PJ;Anguera JA
用于心理健康的移动的应用程序有可能克服获得心理健康护理的障碍，但关于患者是否按预期使用干预措施及其对心理健康结果的影响的信息很少。我们研究的目的是记录和比较美国3种不同的抑郁症自我引导移动的应用程序的使用模式和临床结果。参与者通过基于网络的广告和社交媒体招募，并被随机分配到3个情绪应用程序中的1个。治疗和评估在每位参与者的智能手机或平板电脑上远程进行，与研究人员的接触最少。我们招募了626名讲英语的成年人（≥18岁），根据9项患者健康问卷（PHQ-9）评分≥5分或第10项评分≥2分确定为轻度至中度抑郁。这些应用程序包括：（1）Project：EVO，一款认知训练应用程序，理论上可以通过改善认知控制来缓解抑郁症状，（2）iPST，一款基于抑郁症循证心理治疗的应用程序，以及（3）健康提示，治疗对照。结果为PHQ-9和Sheehan残疾量表评分。治疗依从性以参与者按指示打开和使用应用程序的次数来衡量。我们随机将211名参与者分配到iPST，209名参与者分配到Project：EVO，206名参与者分配到健康提示。在参与者中，77.0%（482/626）的PHQ-9评分>10（中度抑郁）。在使用2个活动应用程序的参与者中，57.9%（243/420）没有下载分配的干预应用程序，但在人口统计学上与下载的参与者没有差异。在基线PHQ-9评分>10的参与者中存在不同的治疗效果，认知训练和解决问题应用程序对情绪的影响大于信息控制应用程序（χ22=6.46，P= 0.04）。针对抑郁症的移动的应用程序似乎对抑郁程度较轻的人影响最大。特别是，在这个样本中，一个旨在参与抑郁症认知相关性的应用程序对抑郁情绪的影响最大。这项研究表明，移动的应用程序可以接触到很多人，并且对中度抑郁症很有用。Clinicaltrials.gov NCT 00540865; https://www.clinicaltrials.gov/ct2/show/NCT00540865（由WebCite存档，网址为http：//www.webcitation.org/6mj8IPqQr）
Mobile apps for mental health have the potential to overcome access barriers to mental health care, but there is little information on whether patients use the interventions as intended and the impact they have on mental health outcomes. The objective of our study was to document and compare use patterns and clinical outcomes across the United States between 3 different self-guided mobile apps for depression. Participants were recruited through Web-based advertisements and social media and were randomly assigned to 1 of 3 mood apps. Treatment and assessment were conducted remotely on each participant’s smartphone or tablet with minimal contact with study staff. We enrolled 626 English-speaking adults (≥18 years old) with mild to moderate depression as determined by a 9-item Patient Health Questionnaire (PHQ-9) score ≥5, or if their score on item 10 was ≥2. The apps were (1) Project: EVO, a cognitive training app theorized to mitigate depressive symptoms by improving cognitive control, (2) iPST, an app based on an evidence-based psychotherapy for depression, and (3) Health Tips, a treatment control. Outcomes were scores on the PHQ-9 and the Sheehan Disability Scale. Adherence to treatment was measured as number of times participants opened and used the apps as instructed. We randomly assigned 211 participants to iPST, 209 to Project: EVO, and 206 to Health Tips. Among the participants, 77.0% (482/626) had a PHQ-9 score >10 (moderately depressed). Among the participants using the 2 active apps, 57.9% (243/420) did not download their assigned intervention app but did not differ demographically from those who did. Differential treatment effects were present in participants with baseline PHQ-9 score >10, with the cognitive training and problem-solving apps resulting in greater effects on mood than the information control app (χ22=6.46, P=.04). Mobile apps for depression appear to have their greatest impact on people with more moderate levels of depression. In particular, an app that is designed to engage cognitive correlates of depression had the strongest effect on depressed mood in this sample. This study suggests that mobile apps reach many people and are useful for more moderate levels of depression. Clinicaltrials.gov NCT00540865; https://www.clinicaltrials.gov/ct2/show/NCT00540865 (Archived by WebCite at http://www.webcitation.org/6mj8IPqQr)
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影响因子：
3.9
作者：
Banos O;Villalonga C;Garcia R;Saez A;Damas M;Holgado-Terriza JA;Lee S;Pomares H;Rojas I
通讯作者：
Rojas I
影响因子：
1.2
作者：
Kuhn, Eric;Greene, Carolyn;Ruzek, Josef
通讯作者：
Ruzek, Josef
影响因子：
12.8
作者：
Bell, Alissa C.;D'Zurilla, Thomas J.
通讯作者：
D'Zurilla, Thomas J.
DOI：
10.1093/jamia/ocv150
发表时间：
2016-05-01
影响因子：
6.4
作者：
Karkar, Ravi;Zia, Jasmine;Kientz, Julie A.
通讯作者：
Kientz, Julie A.
影响因子：
3.4
作者：
Atkins, David C.;Baldwin, Scott A.;Neighbors, Clayton
通讯作者：
Neighbors, Clayton