The use of mobile devices and technology extends to all areas of life and mental health cannot be left behind. Just as there are apps that help control diseases such as hypertension or diabetes, there are others that help deal with depression and its symptoms. A meta-analysis published in the journal Open JAMA Network found “significant reductions in severity” in patients with this disease, who had used 16 of them. Researchers from the University of Seoul (South Korea) estimate that these apps They can mean an improvement in the approach to depressive disorder.
The functions of these applications are to assess patients’ mood through a test and send them guidelines and messages to help them improve their symptoms (such as negativity, apathy or demotivation…) , explains Luis Gutiérrez, member of the Spanish Society. .of Psychiatry and Mental Health (SEPSM). Furthermore, some apps They also have tools that allow teleconsultations with the therapist, adds Carme Carrión, principal researcher of the eHealth Lab group at the Open University of Catalonia (UOC).
The authors claim that these types of applications provide more freedom in terms of patient time and movement. However, they also advocate the need to further develop and refine these mobile device-based treatments, in order to “adapt them to socially disadvantaged populations.”
3.8% of the world’s population (around 280 million people) suffers from depression, according to the World Health Organization (WHO). In low- and middle-income countries, more than 75% receives no treatment, despite the fact that there are many effective therapies. The authors of the work attribute this to the high cost of therapies, fear of stigmatization and lack of awareness of the effectiveness of the treatment, among others.
The interventions analyzed lasted between three and 24 weeks and included both people receiving treatment and those not receiving it. After the study, the authors of the work concluded that, for mobile treatment of depression to be as effective as possible, it should not be extended beyond eight weeks. In addition, it also reduced the patient’s “financial and psychological burdens”, the text adds. They also observed that severity was reduced more in those who were not taking other treatment for depression. Gutiérrez estimates that it will take more time, “at least nine months or a year, to see the patient fully recover.”
It’s easy to see improvement in depressive symptoms within eight weeks if a person has moderate or severe depression, says the psychiatrist. “If I am very depressed, with little action, the symptoms will improve immediately,” adds Gutiérrez. But what would be really interesting for him would be to follow patients over the long term, “to prevent relapses and guarantee that the initial improvement is maintained over time”.
They are not worth replacing psychologists
Carme Carrión and Luis Gutiérrez affirm that this type of applications can never replace therapists. There application This adds value, but what is really important is “how the therapeutic process is designed and this tool is included so that it is effective,” adds the UOC researcher. The SEPSM member highlights its capacity as a complement when the patient does not consult their psychiatrist or psychologist: “These applications can give you, on a daily basis, guidance or a recommendation.
Miguel Ángel López, clinical psychologist at the Jaén Hospital and member of the steering committee of the Spanish Society of Clinical and Health Psychology (SEPCyS), explains that the therapeutic approach to depression is multidisciplinary and personalized for each patient. This specialist doubts the effectiveness of apps to cure depression, as a study from the University of Seoul says, and considers that the idea that depression can be “treated and cured by submitting an application” can be confusing and frustrating for patients.
This research is an analysis of 13 studies that evaluated 16 apps and a total of 1,470 participants between 20 and 40 years old. Gutiérrez (from SEPSM) and López (from SEPCyS) agree that the sample is too small and homogeneous to be able to generalize the results to the entire population, something the authors also acknowledge in the text itself. A UOC study published last September in JMR Publications, in which Carrión participated, concluded that hybrid interventions combining the use of these applications and traditional therapy were more effective. According to its authors, this modality can be more economical for the patient and increase the ability of therapists to treat more people.
Trust an “app” for therapy
The UOC researcher considers that an appropriate mobile application to treat depression must be based on scientific evidence, have health professionals behind its development and clearly specify everything related to the use of patient data. patients. Furthermore, it would be interesting if there was a application which could be integrated into the information systems of the public health system. Thus, the data would be transferred directly to the patient’s medical history, Carrión emphasizes.
This type of applications not only exists for the treatment of depression, but there are also ones for bipolar disorder and schizophrenia, says Gutiérrez, member of SEPSM. One way to distinguish an effective app with evidence from one without it is whether it is branded by a healthcare organization. For example, the Andalusian Agency for Health Quality has the seal of application in good health and Catalonia has AppHi, a catalog of accredited and safe applications for use in therapy. In the United States, the American Psychological Association (APA) has developed a model to evaluate them in five levels, taking into account issues such as data processing, user-friendliness or the existence of clinical trials proving its effectiveness.
Studies like this make it clear that transforming the healthcare system isn’t just about putting more people to work. Everything must be more efficient, and that includes the use of these tools, which accompany people in real time between visits to their therapist, according to Carme Carrión. The UOC researcher highlights the importance of investing in mental health: “We are not only talking about many new people in the health system, but we are talking about tools that can help these people,” Carrión concludes.