A therapist-guided smartphone app for major depression in young adults: A randomized clinical trial
Open accessAbstract
BACKGROUND: Meru Health Program (MHP) is a therapist-guided, 8-week intervention for depression delivered via smartphone. The aim was to test its efficacy in patients with clinical depression in a Finnish university student health service. METHODS: Patients (n=124, women 72.6%, mean age 25y) were stratified based on antidepressant status, and randomized into intervention group receiving MHP plus treatment as usual (TAU), and control group receiving TAU only. Depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scale, was the primary outcome. After baseline (T0), follow-ups were at mid-intervention (T4), immediately post-intervention (T8); 3 months (T20), and 6 months (T32) post-intervention. RESULTS: The intervention group and control group did not have significant differences in depression outcomes throughout end of treatment and follow-up. Among secondary outcomes, increase in resilience (d=0.32, p=0.03) and mindfulness (d=0.57, p=0.002), and reduction in perceived stress (d=-0.52, p=0.008) were greater in MHP+TAU versus TAU at T32; no differences were found in anxiety, sleep disturbances, and quality of life between groups. Post-hoc comparisons of patients on antidepressants showed significantly greater reduction in depression at T32 for MHP+TAU versus TAU (d=-0.73, p=0.01); patients not on antidepressants showed no between-group differences. LIMITATIONS: Limitations include unknown characteristics of TAU, potential bias from patients and providers not being blinded to treatment group, and failure to specify examination of differences by antidepressant status in the protocol. CONCLUSIONS: Most outcomes, including depression, did not significantly differ between MHP+TAU and TAU. Exploratory analysis revealed intervention effect at the end of the 6-month follow-up among patients on antidepressant medication.
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Randomized control trials using online mindfulness interventions addressing students' mental health have proven to be effective.
“Randomized control trials using online mindfulness interventions addressing students’ mental health have proven to be effective [11, 12, 14, 24–26]”
From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [24]
The Discussion describes a randomized trial of a mindfulness-based app among patients recruited from university students’ health services. The Secondary outcomes section reports reduced perceived stress and improved resilience, but the Discussion says the app provided no additional benefit over usual treatment for depression, the trial’s primary target. The broad claim that the intervention was effective therefore overstates this trial’s findings. (LLM, conf=0.88)
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- Authors
- Raevuori, A., Vahlberg, T., Korhonen, T., Hilgert, O., Aittakumpu-Hyden, R., & Forman-Hoffman, V.
- Affiliations
- University of Helsinki (FI)
- University of Turku (FI)
- Meru Health, Inc. (United States) (US)
- Finnish Student Health Service (FI)
- Corresponding author
- Raevuori, Anu
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 286
- Pages
- 228-238
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3128131918
- Cited by
- 52
- References
- 40
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 12 · 2023: 15 · 2022: 11 · 2021: 2
- FWCI
- 8.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Työväentutkimus Vuosikirja (submittedVersion, cc-by-nc-sa)
- UTUPub (University of Turku) (submittedVersion, cc-by-nc-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- major depressive disorder, young adults, mobile application, therapist-guided intervention, university students, antidepressants, resilience, mindfulness, perceived stress, usual care, digital mental health
- MeSH terms
- Smartphone, Adult, Depression, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Mobile Applications
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