Computer-, Smartphone-Based Treatments Effective at Reducing Symptoms of Depression

Computer- and smartphone-based treatments appear to be effective in reducing symptoms of depression, and while it remains unclear whether they are as effective as face-to-face psychotherapy, they offer a promising alternative to address the growing mental health needs spawned by the COVID-19 pandemic, according to research published by the American Psychological Association.

"The year 2020 marked 30 years since the first paper was published on a digital intervention for the treatment of depression. It also marked an unparalleled inflection point in the worldwide conversion of mental health services from face-to-face delivery to remote, digital solutions in response to the COVID-19 pandemic," said lead author Isaac Moshe, MA, a doctoral candidate at the University of Helsinki. "Given the accelerated adoption of digital interventions, it is both timely and important to ask to what extent digital interventions are effective in the treatment of depression, whether they may provide viable alternatives to face-to-face psychotherapy beyond the lab and what are the key factors that moderate outcomes."

The research was published in the journal Psychological Bulletin.

Digital interventions typically require patients to log in to a software program, website or app to read, watch, listen to and interact with content structured as a series of modules or lessons. Individuals often receive homework assignments relating to the modules and regularly complete digitally administered questionnaires relevant to their presenting problems. This allows clinicians to monitor patients' progress and outcomes in cases where digital interventions include human support. Digital interventions are not the same as teletherapy, which has gotten much attention during the pandemic, according to Moshe. Teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy.

"Digital interventions have been proposed as a way of meeting the unmet demand for psychological treatment," Moshe said. "As digital interventions are being increasingly adopted within both private and public health care systems, we set out to understand whether these treatments are as effective as traditional face-to-face therapy, to what extent human support has an impact on outcomes and whether the benefits found in lab settings transfer to real-world settings."

Researchers conducted a meta-analysis of 83 studies testing digital applications for treating depression, dating as far back as 1990 and involving more than 15,000 participants in total, 80% adults and 69.5% women. All of the studies were randomized controlled trials comparing a digital intervention treatment to either an inactive control (e.g., waitlist control or no treatment at all) or an active comparison condition (e.g., treatment as usual or face-to-face psychotherapy) and primarily focused on individuals with mild to moderate depression symptoms.

Overall, researchers found that digital interventions improved depression symptoms over control conditions, but the effect was not as strong as that found in a similar meta-analysis of face-to-face psychotherapy. There were not enough studies in the current meta-analysis to directly compare digital interventions to face-to-face psychotherapy, and researchers found no studies comparing digital strategies with drug therapy.

The digital treatments that involved a human component, whether in the form of feedback on assignments or technical assistance, were the most effective in reducing depression symptoms. This may be partially explained by the fact that a human component increased the likelihood that participants would complete the full intervention, and compliance with therapy is linked to better outcomes, according to Moshe.

One finding that concerned Moshe was that only about half of participants actually completed the full treatment. That number was even lower (25%) in studies conducted in real-world health care settings compared with controlled laboratory experiments. This may help explain why treatments tested in real-world settings were less effective than those tested in laboratories.

"The COVID-19 pandemic has had a major impact on mental health across the globe. Depression is predicted to be the leading cause of lost life years due to illness by 2030. At the same time, less than 1 in 5 people receive appropriate treatment, and less than 1 in 27 in low-income settings. A major reason for this is the lack of trained health care providers," he said. "Overall, our findings from effectiveness studies suggest that digital interventions may have a valuable role to play as part of the treatment offering in routine care, especially when accompanied by some sort of human guidance."

Isaac Moshe, Laura Pulkki-Råback, Yannik Terhorst, Matthias Domhardt, Paula Philippi, Harald Baumeister, Pim Cuijpers, Ioana Cristea, Lasse Sander.
Digital interventions for the treatment of depression: A meta-analytic review.
Psychological Bulletin, 2021. doi: 10.1037/bul0000334

Most Popular Now

AI Points the Way to Better Doctor-Patie…

A computer analysis of hundreds of thousands of secure email messages between doctors and patients found that most doctors use language that is too complex for their patients to understand...

Open Call DIGITAL-2021-DEPLOY-01-TWINS-H…

The development of digital twins in healthcare (DTH) has progressed substantially, profiting from advances in science and technology. In order to exploit their benefits in view of better prevention approaches...

Mayo Clinic Researchers Use AI, Biomarke…

Treatment options for rheumatoid arthritis have often relied on trial and error. Now Mayo Clinic researchers are exploring the use of artificial intelligence (AI) and pharmacogenomics to predict how patients...

Mjog by Livi Launches Remote Monitoring …

Mjog by Livi has launched a remote monitoring tool that will help GPs support and monitor people with depression through messages sent to their smartphones. The latest data from the Office...

Could EKGs Help Doctors use AI to Detect…

Pulmonary embolisms are dangerous, lung-clogging blot clots. In a pilot study, scientists at the Icahn School of Medicine at Mount Sinai showed for the first time that artificial intelligence (AI)...

Computer Model of Blood Enzyme

Membrane-associated proteins play a vital role in a variety of cellular processes, yet little is known about the membrane-association mechanism. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is one such protein with an...

4.5 Million Euros in EU Funding for Saar…

This year, three computer scientists from Saarbrücken were awarded an "ERC Starting Grant" by the European Research Council. This award, endowed with 1.5 million euros each, is among the most...

2022 EU4Health Work Programme Adopted to…

Today the Commission has adopted the second EU4Health work programme. In 2022, the EU4Health will continue to invest in building stronger, more resilient health systems and pave the way for...

Five NHS Trusts in Surrey and Sussex to …

A consortium of NHS trusts that covers a population of circa 1.2 million will gain immediate access to important patient imaging, and will mobilise a regional workforce for patients, following...

Helping Cancer Patients Avoid Excessive …

A Case Western Reserve University-led team of scientists has used Artificial Intelligence (AI) to identify which patients with certain head and neck cancers would benefit from reducing the intensity of...

The Programme for the Union's Action in …

On 24 March 2021, Regulation (EU) 2021/522 of the European Parliament and of the Council1 was adopted as part of the Multiannual Financial Framework for the 2021-2027 period. That Regulation...

CliniSys Acquires HORIZON Lab Systems an…

CliniSys is announcing the recent acquisition of HORIZON Lab Systems and the combination with Sunquest Information Systems, as CliniSys. This acquisition and Sunquest combination creates one of the world’s...