Can smartphone applications successfully treat serious mental illnesses?

Key points

  • Researchers tested a new smartphone app for severe mental illness on 315 people in 45 states.
  • They found that after 30 days of using the app, the symptoms of anxiety and depression were reduced.
  • In addition, participants reported increased self-esteem and a positive view of their recovery.

Medication may still be the first line of treatment for serious mental illnesses such as depression, bipolar disorder, and schizophrenia, but the future of those who manage these disorders may include digital components.

In a fully remote randomized controlled trial testing digital interventions for severe mental illness, researchers created a smartphone app called CORE, which contains daily game-like exercises to help people with severe mental illness regain Evaluate their beliefs.

“There are many barriers to the treatment of patients with severe mental illness (for example, cost, accessibility, availability, stigma),” said co-author Guy Doron, professor of psychology at Reichman University in Israel and co-founder of GGTude. ) Say. The company that created the CORE application.

Doron pointed out that researching people with mental illness can also be difficult because of the high cost and problems in attracting participants and persuading them to continue the intervention. The trial attempts to evaluate potential ways to overcome these obstacles-by identifying and contacting people with severe mental illness, and evaluating the application intervention itself.

The researchers said the test results were published in Journal of Medical Internet Research, Encouraging.

Study the study carefully

The CORE app was tested among 315 people in 45 states, who were recruited through online advertising on Google and Facebook in 2020.

Participants self-reported as having a mental illness: 35% had bipolar disorder, 43% had severe depression, and 22% had schizophrenia or schizoaffective disorder. The majority are unemployed (67%), women (86%) and white (80%). Clinicians used various screening tools to evaluate them for severe mental illness.

Participants were asked to use the smartphone app for three minutes a day for 30 days. On their screens, the statements they see are consistent or inconsistent with negative views of themselves, the world, and the future. Then they can choose to brush these statements on themselves or get rid of them. If they swipe to themselves, the app will provide feedback to them to help them deal with unhealthy thoughts and encourage healthy thoughts.

Guy Doron, PhD

The CORE application is low cost, easy to use, and can be used on any smartphone.

— Guy Doron, PhD

At the end of the study period, the participants had depressive symptoms (an average decrease of 7 points on the Beck Depression Scale) and anxiety (an average decrease of 4 points on the Generalized Anxiety Disorder 7 Scale). They also reduced dysfunction by an average of 5 points on the Sheehan Disability Scale.

Other popular findings include increased self-esteem and positive perceptions related to one’s recovery (evaluated by the Rosenberg Self-Esteem Scale and the Rehabilitation Evaluation Scale, respectively).

After 60 days, even after they stopped using the app, the test group observed changes that did not apply to the control group.

In addition to the lack of diversity in the test group, the high dropout rate (63%) is a weakness of the study. “This reminds us that while the CORE app may be effective and useful for many patients, it is not for everyone,” Duolun said.

However, he believes that the CORE application is usable and acceptable for people with severe mental illness, and can effectively reduce mental symptoms and disabilities, and improve recovery attitude and self-esteem. “The CORE application is low-cost, easy to use, and can be used on any smartphone,” he added.

The future of mental health treatment

“Apps cannot replace prescription antidepressants and treatments, but can only be used as adjuvant treatments,” said Leela R. Magavi, MD, a psychiatrist at Hopkins University and regional medical director of Mindpath Health. “People with moderate to severe depression usually need a prescription for antidepressants.”

Dr. Magavi said that some of her patients found that their anxiety and depression symptoms improved after using the app. But she also warned that some of them said that using the app would lead to more isolated behaviors and depressive symptoms.

“Apps can limit social and contact-induced anxiety situations, which may lead to avoidance and increased anxiety in the long run,” Dr. Magavi explained. “They can also increase screen time, which can have a detrimental effect on mood, sleep and overall mental health.”

Leela R. Magavi, MD

The application is not a substitute for prescription antidepressants and therapies, it can only be used as an adjuvant treatment. People with moderate to severe depression usually need to prescribe antidepressants.

— Leela R. Magavi, MD

Although smartphone applications may have a place in mental health treatment, Dr. Magavi emphasized that there are more pressing issues that need to be addressed, such as a severe shortage of child and adolescent psychiatrists and adult psychiatrists.

“Due to the pandemic, the incidence of mental illness has increased exponentially, and many people who suffer from COVID-19 have to wait several months at a time to see a psychiatrist,” said Dr. Magavi. “Many psychiatrists and therapists have very full schedules and there are no vacancies for new patients. The doctors are exhausted and they have experienced depression themselves.”

In these difficult times, any promotion of open and honest dialogue about mental health is positive. “The media helps raise awareness and normalize mental illness,” said Dr. Magavi. “People from all backgrounds talk about their feelings openly on national television. It’s important to let children see this and know that it’s okay to express their emotions publicly. This does not equate to weakness in any way.”

What this means to you

If you are concerned about your mental health, or find it more difficult to manage your emotions or daily life needs than usual, please make an appointment with your primary care provider. You can also ask your local National League for Mental Illness (NAMI) representative to help you find affordable mental health services in your area.

There are many mental health apps available, from Moodfit (a free app that helps you track emotions and deal with negative emotions) to Sanvello (designed to provide cognitive behavioral therapy tools to help treat mild to moderate anxiety and depression ). But for severe mental illness, you may need comprehensive treatment, such as counseling and/or medication.