Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety : Quasiexperimental, Pre-Postintervention Study

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Economides , M , Ranta , K , Nazander , A , Hilgert , O , Goldin , P R , Raevuori , A & Forman-Hoffman , V 2019 , ' Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety : Quasiexperimental, Pre-Postintervention Study ' , JMIR mhealth and uhealth , vol. 7 , no. 8 , 14284 . https://doi.org/10.2196/14284

Title: Long-Term Outcomes of a Therapist-Supported, Smartphone-Based Intervention for Elevated Symptoms of Depression and Anxiety : Quasiexperimental, Pre-Postintervention Study
Author: Economides, Marcos; Ranta, Kristian; Nazander, Albert; Hilgert, Outi; Goldin, Philippe R.; Raevuori, Anu; Forman-Hoffman, Valerie
Contributor: University of Helsinki, Department of Public Health
Date: 2019-08-26
Number of pages: 13
Belongs to series: JMIR mhealth and uhealth
ISSN: 2291-5222
URI: http://hdl.handle.net/10138/319383
Abstract: Background: Depression is one of the most common mental health disorders and severely impacts one's physical, psychological, and social functioning. To address access barriers to care, we developed Ascend-a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. A previous feasibility study with 102 adults with elevated depression reported that Ascend is associated with a postintervention reduction in depression symptoms. Objective: We aimed to examine whether Ascend is associated with a reduction in symptoms of anxiety, and importantly, whether reductions in symptoms of depression and anxiety are maintained up to 12-months postintervention. Methods: We assessed whether the previously reported, end-of-treatment improvements seen in the 102 adults with elevated symptoms of depression extended up to 12 months posttreatment for depression symptoms (measured by the Patient Health Questionnaire-9 [PHQ-9]) and up to 6 months posttreatment for anxiety symptoms (added to the intervention later and measured using the Generalized Anxiety Disorder-7 [GAD-7] scale). We used linear mixed effects models with Tukey contrasts to compare time points and reported intention-to-treat statistics with a sensitivity analysis. Results: The intervention was associated with reductions in symptoms of depression that were maintained 12 months after the program (6.67-point reduction in PHQ-9 score, 95% CI 5.59-7.75; P= 10) reported clinically significant improvement at the 12-month follow-up (at least 50% reduction in PHQ-9 score and postprogram score Conclusions: There is limited evidence on whether outcomes associated with smartphone-based interventions for common mental health problems are maintained posttreatment. Participants who enrolled in Ascend experienced clinically significant reductions in symptoms of depression and anxiety that were maintained for up to 1 year and 6 months after the intervention, respectively. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and anxiety.
Subject: digital health
depression
anxiety
mindfulness
CBT
online intervention
smartphone intervention
COGNITIVE-BEHAVIORAL THERAPY
MENTAL-HEALTH INTERVENTIONS
PSYCHOLOGICAL TREATMENTS
METAANALYSIS
DISORDER
VALIDATION
RELAPSE
PHQ-9
PSYCHOTHERAPY
PREVENTION
3142 Public health care science, environmental and occupational health
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