A randomized controlled trial on a smartphone self-help application (Be Good to Yourself) to reduce depressive symptoms
Open accessAbstract
Depressive symptoms are common, yet only a subgroup of individuals receive adequate treatment. To reduce the treatment gap, several online self-help programs have been developed, yielding small to moderate effects. We developed a smartphone self-help application addressing depressive symptoms. We sought to evaluate its feasibility and efficacy in participants reporting a subjective need for help (a diagnosis of depression was not mandatory). We conducted a randomized controlled trial (N = 90). The primary outcome was a reduction of depressive symptoms measured with the Patient Health Questionnaire-9 (PHQ-9). Secondary outcomes included improved self-esteem (Rosenberg Self-Esteem Scale) and quality of life (WHOQOL-BREF). The intervention group obtained access to the application for four weeks, the wait-list group received access after the post assessment. No group differences emerged in either outcome in intention-to-treat analyses. Per protocol analyses with frequent users (i.e., several times a week or more) yielded a small effect size (η 2p = 0.049) at trend level on the reduction of depressive symptoms in favor of the treatment group. However, 39% of the participants did not use the application frequently. Mobile self-help applications represent a promising addition to existing treatments, but it is important to increase patients' motivation to use them.
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Randomized controlled trials have shown that app-based interventions can effectively improve depressive and anxiety symptoms compared with waiting list, alternative care, or control conditions.
“Randomized controlled trials (RCTs) have shown that app-based interventions can effectively improve depressive and anxiety symptoms compared with waiting list, alternative care, or control conditions [29-34].”
Ludtke et al only offered self-reported app usage data.
“Ludtke et al [29] only offered self-reported app usage data”
From Digital Mental Health Interventions for Depression: Scoping Review of User Engagement (2022) · cites this paper as [29]
With the exception of Ludtke et al, all studies that reported on app usage indicated using backend data from the app to monitor app usage in the test condition(s).
“With the exception of Ludtke et al [29], all studies that reported on app usage indicated using backend data from the app to monitor app usage in the test condition(s).”
From Digital Mental Health Interventions for Depression: Scoping Review of User Engagement (2022) · cites this paper as [29]
The majority of RCT studies on depressive disorders showed that participants who received intervention apps significantly improved their symptoms (depression, anxiety, etc) compared with the waiting list, alternative care, or control conditions.
“The majority of these studies showed that participants who received intervention apps significantly improved their symptoms (depression, anxiety, etc) compared with the waiting list [18,175], alternative care [168], or control conditions [178,180].”
From Smartphone Apps for the Treatment of Mental Disorders: Systematic Review (2020) · cites this paper as [18]
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- Authors
- Lüdtke, T., Pult, L. K., Schröder, J., Moritz, S., & Bücker, L.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Lüdtke, Thies
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 269
- Pages
- 753-762
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2889419542
- Cited by
- 122
- References
- 52
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 8 · 2023: 10 · 2022: 11 · 2021: 17 · 2020: 52 · 2019: 8
- FWCI
- 24.28
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
- 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
- depressive symptoms, mobile mental health, self-esteem, quality of life, treatment gap, user engagement, PHQ-9
- MeSH terms
- Smartphone, Adult, Depression, Female, Humans, Male, Middle Aged, Quality of Life, Self Care, Self Concept, Self Report, Mobile Applications
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