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
Open accessAbstract
BACKGROUND: Mobile 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. METHOD: Community-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. RESULTS: Retention 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. CONCLUSIONS: The 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 REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN 12610000625077.
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The various AI-augmented applications presented in this review have achieved encouraging positive mental health outcomes, while leveraging and supporting the benefits of online platforms, including scalability, versatility, cost-effectiveness, and personalization.
“The various AI-augmented applications presented in this review have achieved encouraging positive mental health outcomes, while leveraging and supporting the benefits of online platforms, including scalability, versatility, cost-effectiveness, and personalization (8, 9, 95–97).”
From Examining the role of AI technology in online mental healthcare: opportunities, challenges, and implications, a mixed-methods review (2024) · cites this paper as [96]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe myCompass 2 program is highly similar to the original myCompass program.
“The reason for this null finding was unclear, as the program is highly similar to the original myCompass program (Proudfoot et al., 2013)”
From Predictors of acceptability and engagement in a self-guided online program for depression and anxiety (2021) · cites this paper as Proudfoot et al., 2013
The Methods > Interventions passages describe the original myCompass program, including symptom self-monitoring and skill-building modules (page not provided). The paper does not describe myCompass 2, so it cannot establish that the two programs are highly similar. (LLM, conf=0.82)
Experimental — accuracy not yet measuredParticularly in panic disorder, the use of mobile tools in treatment is promising because treatment intervenes where panic attacks take place, in the everyday lives of those affected.
“Particularly in the case of PD, the use of mobile tools in treatment is promising, as the treatment intervenes where panic attacks take place, namely in the everyday lives of those affected (Christoforou et al., 2017; Ivanova et al., 2016; Proudfoot et al., 2013).”
From A mobile application for panic disorder and agoraphobia: Insights from a multi-methods feasibility study (2020) · cites this paper as Proudfoot et al., 2013
The Background (page unavailable) says mobile phones can provide psychotherapeutic advice in real time and real-world contexts, supporting the everyday-life rationale. The Methods > Interventions section describes real-time symptom monitoring, and the Discussion reports benefits for people with depression, anxiety and stress. The paper does not specifically address panic disorder or show that the intervention reaches people where panic attacks occur. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFor secondary hypotheses (H3-4), a sample of 110 per condition is required to find a small effect size of f = 0.18 between active conditions relative to control over three assessment time points with 90% power (α = .05, r = 0.5).
“For secondary hypotheses (H3-4), a sample of 110 per condition is required to find a small effect size of f = 0.18 (based on a previous study by Proudfoot et al. [29]) between active conditions relative to control over the three assessment time points (baseline, post, and 6 month follow-up) with 90% power ( α = .05, r = 0.5 between repeated measures).”
From A brief intervention to increase uptake and adherence of an online program for depression and anxiety: Protocol for the Enhancing Engagement with Psychosocial Interventions (EEPI) Randomized Controlled Trial (2019) · cites this paper as [29]
The Methods (Sample & setting) estimate a small between-group effect of d = 0.2, and the Results (Effect size, Table 5) report effects as Cohen’s d. The cited paper does not report f = 0.18, so it supports using a small effect as a basis for planning but not the specific effect-size value attributed to it. The 110-per-condition power calculation is the citing authors’ own, not a result attributed to Proudfoot et al. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA transdiagnostic EMI comprising online CBT modules and SMS reminders for treating stress and anxiety was associated with lower stress levels than a waitlist control (d = 0.34 at post-test).
“A study evaluating a transdiagnostic EMI comprising online CBT modules and SMS reminders for treating stress and anxiety 37 was associated with lower stress levels than a waitlist control ( d = 0.34 at post-test).”
From Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: A systematic review (2016) · cites this paper as [37]
The Methods > Interventions section describes myCompass as offering online modules derived partly from CBT and optional SMS reminders. Results > Outcomes at post-intervention reports significantly greater improvement in stress than the waitlist group. However, Table 5 in Results > Effect size gives the post-test stress effect as d = .35 using observed means or .28 using estimated marginal means, not .34; no page numbers are provided in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Studies examining EMIs in reducing stress demonstrated positive effects for EMI relative to controls.
“Studies examining EMIs in reducing stress demonstrated positive effects for EMI relative to controls. 34,36,37”
From Effectiveness of mobile technologies delivering Ecological Momentary Interventions for stress and anxiety: A systematic review (2016) · cites this paper as [37]
The Results (Outcomes at post-intervention; page not available) report significantly greater improvement in stress for myCompass than for the waitlist group. They do not report a significant stress benefit over the attention-control group, so the claim is supported for one control condition but overgeneralizes across controls. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe original myCompass self-guided program has been shown to reduce symptoms of depression and anxiety in previous community studies (n = 89; n = 720).
“The original myCompass self-guided program has been shown to reduce symptoms of depression and anxiety in previous community studies (n = 89; n = 720) (Clarke et al., 2016; Proudfoot et al., 2013).”
From Predictors of acceptability and engagement in a self-guided online program for depression and anxiety (2021) · cites this paper as Proudfoot et al., 2013
Some mobile health apps have demonstrated efficacy in definitive trials.
“While some apps have demonstrated efficacy in definitive trials [2-5], others have performed poorly [6-9].”
From A Library of Analytic Indicators to Evaluate Effective Engagement with Consumer mHealth Apps for Chronic Conditions: Scoping Review (2019) · cites this paper as [2]
Dropout attrition in the intervention arm of the RCT was high, especially among employed participants.
“dropout attrition in the intervention arm of the RCT was high, especially among employed participants.”
From Therapeutic alliance with a fully automated mobile phone and web-based intervention: secondary analysis of a randomized controlled trial (2016) · cites this paper as [28]
We found only one randomized clinical trial specifically targeting adults with mild-to-moderate depression.
“We found only one such study specifically targeting adults with mild-to-moderate depression [50,51].”
From MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial (2016) · cites this paper as [50]
Treatment gains in the myCompass study were maintained at 3-month follow-up, and improvements in the attention control condition matched those of the myCompass group.
“Treatment gains were maintained at 3-month follow-up, and improvements in the attention control condition matched those of the myCompass group [50].”
From MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial (2016) · cites this paper as [50]
In the myCompass study, participants who used the CBT-based myCompass app reported improvements in depression and anxiety at 7-week post-test compared to an attention control intervention and a waiting list condition.
“In this study, participants who used the CBT-based myCompass app, delivered via mobile phone and Internet, reported improvements in depression and anxiety at 7-week post-test compared to an attention control intervention and a waiting list condition.”
From MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial (2016) · cites this paper as [50]
People experiencing severe depression and anxiety symptoms, and frequent suicidal ideation, use DMHIs once they are released into the community, although the programs are often not designed for these clients.
“Another important clinical consideration is that people experiencing severe depression and anxiety symptoms, and frequent suicidal ideation, use DMHIs once they are released into the community, although the programs are often not designed for these clients (eg, myCompass and THIS WAY UP) [40-42].”
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- Authors
- Proudfoot, J., Clarke, J., Birch, M.-R., Whitton, A. E., Parker, G., Manicavasagar, V., Harrison, V., Christensen, H., & Hadzi-Pavlovic, D.
- Affiliations
- Black Dog Institute (AU)
- UNSW Sydney (AU)
- Corresponding author
- Proudfoot, Judith
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2013-11-18
- Volume
- 13
- Issue
- 1
- Pages
- 312-312
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC4225666
- OpenAlex
- W2122677855
- Cited by
- 264
- References
- 33
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 17 · 2023: 21 · 2022: 20 · 2021: 25 · 2020: 29 · 2019: 24 · 2018: 30 · 2017: 33 · 2016: 21 · 2015: 25 · 2014: 10
- FWCI
- 28.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Online - ORO (The Open University) (acceptedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- Funders
- Australian Government
- Medical Research Council
- National Health and Medical Research Council (510135)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- self-guided treatment, mild to moderate depression, anxiety, stress, work functioning, social functioning, automated intervention, treatment retention
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Depression, Female, Humans, Male, Middle Aged, Patient Compliance, Self Care, Severity of Illness Index, Social Adjustment, Stress, Psychological, Therapy, Computer-Assisted, Program Evaluation, Treatment Outcome, Internet, Cell Phone
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