Significant reduction in depressive symptoms among patients with moderately-severe to severe depressive symptoms after participation in a therapist-supported, evidence-based mobile health program delivered via a smartphone app

Abstract

Depression is a debilitating disorder associated with poor health outcomes, including increased comorbidity and early mortality. Despite the advent of new digital health interventions, few have been tested among patients with more severe forms of depression. As such, in an intent-to-treat study we examined whether 218 patients with at least moderately severe depressive symptoms (PHQ-9 ≥ 15) experienced significant reductions in depressive symptoms after participation in a therapist-supported, evidence-based mobile health (mHealth) program, Meru Health Program (MHP). Patients with moderately severe and severe depressive symptoms at pre-program assessment experienced significant decreases in depressive symptoms at end-of treatment (mean [standard deviation] PHQ-9 reduction = 8.30 [5.03], Hedges' g = 1.64, 95% CI [1.44, 1.85]). Also, 34% of patients with at least moderately severe depressive symptoms at baseline and 29.9% of patients with severe depressive symptoms (PHQ-9 ≥ 20) at baseline responded to the intervention at end-of-treatment, defined as experiencing ≥50% reduction in PHQ-9 score and a post-program PHQ-9 score lower than 10. Limitations include use lack of a control group and no clinical diagnostic information. Future randomized trials are warranted to test the MHP as a scalable solution for patients with more severe depressive symptoms.

Keywords

• Depression
• Mobile health interventions
• Digital health interventions
• Severe depression