Impact of a mobile phone and web program on symptom and functional outcomes for people with mild-to-moderate depression, anxiety and stress: a randomised controlled trial

BackgroundMobile phone-based psychological interventions enable real time self-monitoring and self-management, and large-scale dissemination. However, few studies have focussed on mild-to-moderate symptoms where public health need is greatest, and none have targeted work and social functioning. This study reports outcomes of a CONSORT-compliant randomised controlled trial (RCT) to evaluate the efficacy of myCompass, a self-guided psychological treatment delivered via mobile phone and computer, designed to reduce mild-to-moderate depression, anxiety and stress, and improve work and social functioning.MethodCommunity-based volunteers with mild-to-moderate depression, anxiety and/or stress (N = 720) were randomly assigned to the myCompass program, an attention control intervention, or to a waitlist condition for seven weeks. The interventions were fully automated, without any human input or guidance. Participants’ symptoms and functioning were assessed at baseline, post-intervention and 3-month follow-up, using the Depression, Anxiety and Stress Scale and the Work and Social Adjustment Scale.ResultsRetention rates at post-intervention and follow-up for the study sample were 72.1% (n = 449) and 48.6% (n = 350) respectively. The myCompass group showed significantly greater improvement in symptoms of depression, anxiety and stress and in work and social functioning relative to both control conditions at the end of the 7-week intervention phase (between-group effect sizes ranged from d = .22 to d = .55 based on the observed means). Symptom scores remained at near normal levels at 3-month follow-up. Participants in the attention control condition showed gradual symptom improvement during the post-intervention phase and their scores did not differ from the myCompass group at 3-month follow-up.ConclusionsThe myCompass program is an effective public health program, facilitating rapid improvements in symptoms and in work and social functioning for individuals with mild-to-moderate mental health problems.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN 12610000625077

[1]  D. Fairclough Design and Analysis of Quality of Life Studies in Clinical Trials, Second Edition , 2010 .

[2]  P. Lovibond,et al.  Manual for the Depression Anxiety Stress Scales. 2 , 1995 .

[3]  Kimberly R. Zlomke,et al.  Psychometric properties of internet administered versions of Penn State Worry Questionnaire (PSWQ) and Depression, Anxiety, and Stress Scale (DASS) , 2009, Comput. Hum. Behav..

[4]  H A Pincus,et al.  Barriers to mental health treatment: results from the National Comorbidity Survey Replication , 2010, Psychological Medicine.

[5]  Patricio Cumsille,et al.  4 Methods for Handling Missing Data , 2012 .

[6]  R Hardy,et al.  Methods for handling missing data , 2009 .

[7]  H. Christensen,et al.  Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review , 2010, BMC psychiatry.

[8]  P. Lovibond,et al.  The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. , 1995, Behaviour research and therapy.

[9]  Gerhard Andersson,et al.  Internet-Based Treatment of Depression: A Randomized Controlled Trial Comparing Guided with Unguided Self-Help , 2011, Cognitive behaviour therapy.

[10]  P. Emmelkamp,et al.  Online cognitive-behavioural treatment of bulimic symptoms: a randomized controlled trial. , 2013, Clinical psychology & psychotherapy.

[11]  H. Christensen,et al.  Adherence in Internet Interventions for Anxiety and Depression: Systematic Review , 2009, Journal of medical Internet research.

[12]  G. Andersson,et al.  Please Scroll down for Article Cognitive Behaviour Therapy Internet-based and Other Computerized Psychological Treatments for Adult Depression: a Meta-analysis , 2022 .

[13]  D. Fairclough Design and analysis of quality of life studies in clinical trials , 2002, Quality of Life Research.

[14]  Vikram Patel,et al.  No health without mental health , 2007, The Lancet.

[15]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[16]  G. Patton,et al.  A mobile phone application for the assessment and management of youth mental health problems in primary care: health service outcomes from a randomised controlled trial of mobiletype , 2013, BMC Family Practice.

[17]  Michelle G. Craske,et al.  Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis , 2010, PloS one.

[18]  C. Beevers,et al.  Effectiveness of a Novel Integrative Online Treatment for Depression (Deprexis): Randomized Controlled Trial , 2009, Journal of medical Internet research.

[19]  H. Christensen,et al.  Internet-based mental health programs: a powerful tool in the rural medical kit. , 2007, The Australian journal of rural health.

[20]  G. Andrews Placebo response in depression: Bane of research, boon to therapy , 2001, British Journal of Psychiatry.

[21]  G. Parker,et al.  Mobile mental health: Review of the emerging field and proof of concept study , 2011, Journal of mental health.

[22]  M. Stein,et al.  Development and validation of an Overall Anxiety Severity And Impairment Scale (OASIS) , 2006, Depression and anxiety.

[23]  Brady T. West,et al.  Analyzing Longitudinal Data With the Linear Mixed Models Procedure in SPSS , 2009, Evaluation & the health professions.

[24]  D. Moher,et al.  CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials , 2010, Journal of pharmacology & pharmacotherapeutics.

[25]  J. Proudfoot The future is in our hands: The role of mobile phones in the prevention and management of mental disorders , 2013, The Australian and New Zealand journal of psychiatry.

[26]  R. Kessler,et al.  The economic burden of depression and the cost‐effectiveness of treatment , 2003, International journal of methods in psychiatric research.

[27]  P. Bebbington,et al.  Psychosis Screening Questionnaire , 2014 .

[28]  G. Patton,et al.  A mobile phone application for the assessment and management of youth mental health problems in primary care: a randomised controlled trial , 2011, BMC family practice.

[29]  N. Black CONSORT , 1996, The Lancet.

[30]  G. Freedman,et al.  Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010 , 2013, PLoS medicine.

[31]  Kathleen M Griffiths,et al.  Effectiveness of a Web-Based Cognitive-Behavioral Tool to Improve Mental Well-Being in the General Population: Randomized Controlled Trial , 2012, Journal of medical Internet research.

[32]  J. Rosenbaum,et al.  Placebo response in depression , 2002, Dialogues in clinical neuroscience.

[33]  D. Moher,et al.  CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials , 2010, BMC medicine.

[34]  J. Mundt,et al.  The Work and Social Adjustment Scale: a simple measure of impairment in functioning. , 2002, The British journal of psychiatry : the journal of mental science.

[35]  J Li,et al.  Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies , 2010, Psychological Medicine.

[36]  Gavin Andrews,et al.  CBT for depression: a pilot RCT comparing mobile phone vs. computer , 2013, BMC Psychiatry.