Smartphone Applications for the Treatment of Depressive Symptoms: A Meta-Analysis and Qualitative Review

Abstract

Background

Emerging research indicates that the use of smartphone mental health applications (apps) could be used as an adjunctive therapy for individuals with depression, especially those who have difficulty accessing conventional therapies. The adoption and ownership of smart-phone technology continues to increase in developed and developing nations, and could provide widespread and cost-effective evidence-based treatments for depressive symptoms.

Methods

The primary objective of this meta-analysis was to quantitatively evaluate the effects of smartphone mental health app interventions on depressive symptoms. Identified studies were qualitatively reviewed to address the following secondary objectives: (1) identify the types of smart-phone apps currently being used to target depression; (2) identify factors associated with positive response to smartphone apps in depression; (3) provide directives for future research and app development; and (4) characterize the therapeutic opportunity of smartphone app interventions among individuals with depression.

Results

The results indicate that there may be some therapeutic opportunity with smartphone interventions as an adjunctive treatment for depression. In particular, we observed a small effect in favor of smartphone app interventions for reducing depressive symptoms. However, because of the significant heterogeneity across studies, continued research among more homogenous samples is warranted to determine whether these interventions might have larger (ie, more clinically relevant) effects in specific subpopulations and/or whether specific app characteristics produce larger effects.

Conclusions

The current study highlights some key areas of priority going forward, particularly concerning the design of future studies and the development of novel technologies with a user-centered focus.