A Therapist-guided Smartphone App for Major Depression in Young Adults: A Randomized Clinical Trial

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Raevuori , A , Vahlberg , T , Korhonen , T , Hilgert , O , Aittakumpu-Hyden , R & Forman-Hoffman , V 2021 , ' A Therapist-guided Smartphone App for Major Depression in Young Adults: A Randomized Clinical Trial ' , Journal of Affective Disorders , vol. 286 , pp. 228-238 . https://doi.org/10.1016/j.jad.2021.02.007

Title: A Therapist-guided Smartphone App for Major Depression in Young Adults: A Randomized Clinical Trial
Author: Raevuori, Anu; Vahlberg, Tero; Korhonen, Tellervo; Hilgert, Outi; Aittakumpu-Hyden, Raija; Forman-Hoffman, Valerie
Contributor organization: HUS Psychiatry
Department of Public Health
Clinicum
Nuorisopsykiatria
Helsinki University Hospital Area
University of Helsinki
Institute for Molecular Medicine Finland
Tellervo Korhonen / Principal Investigator
University Management
Genetic Epidemiology
Date: 2021-05-01
Language: eng
Number of pages: 11
Belongs to series: Journal of Affective Disorders
ISSN: 0165-0327
DOI: https://doi.org/10.1016/j.jad.2021.02.007
URI: http://hdl.handle.net/10138/328509
Abstract: Background: Meru Health Program (MHP) is a therapist-guided, 8-week intervention for depression delivered via smartphone. The aim was to test its efficacy in patients with clinical depression in a Finnish university student health service. Methods: Patients (n=124, women 72.6%, mean age 25y) were stratified based on antidepressant status, and randomized into intervention group receiving MHP plus treatment as usual (TAU), and control group receiving TAU only. Depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scale, was the primary outcome. After baseline (T0), follow-ups were at mid-intervention (T4), immediately post-intervention (T8); 3 months (T20), and 6 months (T32) post-intervention. Results: The intervention group and control group did not have significant differences in depression outcomes throughout end of treatment and follow-up. Among secondary outcomes, increase in resilience (d=0.32, p=0.03) and mindfulness (d=0.57, p=0.002), and reduction in perceived stress (d=-0.52, p=0.008) were greater in MHP+TAU versus TAU at T32; no differences were found in anxiety, sleep disturbances, and quality of life between groups. Post-hoc comparisons of patients on antidepressants showed significantly greater reduction in depression at T32 for MHP+TAU versus TAU (d=-0.73, p=0.01); patients not on antidepressants showed no between-group differences. Limitations: Limitations include unknown characteristics of TAU, potential bias from patients and providers not being blinded to treatment group, and failure to specify examination of differences by antidepressant status in the protocol. Conclusions: Most outcomes, including depression, did not significantly differ between MHP+TAU and TAU. Exploratory analysis revealed intervention effect at the end of the 6-month follow-up among patients on antidepressant medication.Background: Meru Health Program (MHP) is a therapist-guided, 8-week intervention for depression delivered via smartphone. The aim was to test its efficacy in patients with clinical depression in a Finnish university student health service.& nbsp; Methods: Patients (n=124, women 72.6%, mean age 25y) were stratified based on antidepressant status, and randomized into intervention group receiving MHP plus treatment as usual (TAU), and control group receiving TAU only. Depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scale, was the primary outcome. After baseline (T0), follow-ups were at mid-intervention (T4), immediately post-intervention (T8); 3 months (T20), and 6 months (T32) post-intervention.& nbsp; Results: The intervention group and control group did not have significant differences in depression outcomes throughout end of treatment and follow-up. Among secondary outcomes, increase in resilience (d=0.32, p=0.03) and mindfulness (d=0.57, p=0.002), and reduction in perceived stress (d=-0.52, p=0.008) were greater in MHP+TAU versus TAU at T32; no differences were found in anxiety, sleep disturbances, and quality of life between groups. Post-hoc comparisons of patients on antidepressants showed significantly greater reduction in depression at T32 for MHP+TAU versus TAU (d=-0.73, p=0.01); patients not on antidepressants showed no between-group differences.& nbsp; Limitations: Limitations include unknown characteristics of TAU, potential bias from patients and providers not being blinded to treatment group, and failure to specify examination of differences by antidepressant status in the protocol.& nbsp; & nbsp;Conclusions: Most outcomes, including depression, did not significantly differ between MHP+TAU and TAU. Exploratory analysis revealed intervention effect at the end of the 6-month follow-up among patients on anti-depressant medication.
Subject: COLLABORATIVE CARE
DISORDERS
Depression
Depressive disorder
FACET MINDFULNESS QUESTIONNAIRE
INDEX
Internet-based intervention
PHARMACOTHERAPY
PSYCHOTHERAPY
Randomized controlled trial
STRESS
Smartphone
217 Medical engineering
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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