Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Central Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Psychol Med. 2022 Feb;52(3):457-466. doi: 10.1017/S0033291720002081. Epub 2020 Jul 6.
BACKGROUND: There is evidence that depression can be prevented; however, traditional approaches face significant scalability issues. Digital technologies provide a potential solution, although this has not been adequately tested. The aim of this study was to evaluate the effectiveness of a new smartphone app designed to reduce depression symptoms and subsequent incident depression amongst a large group of Australian workers. METHODS: A randomized controlled trial was conducted with follow-up assessments at 5 weeks and 3 and 12 months post-baseline. Participants were employed Australians reporting no clinically significant depression. The intervention group (N = 1128) was allocated to use HeadGear, a smartphone app which included a 30-day behavioural activation and mindfulness intervention. The attention-control group (N = 1143) used an app which included a 30-day mood monitoring component. The primary outcome was the level of depressive symptomatology (PHQ-9) at 3-month follow-up. Analyses were conducted within an intention-to-treat framework using mixed modelling. RESULTS: Those assigned to the HeadGear arm had fewer depressive symptoms over the course of the trial compared to those assigned to the control (F3,734.7 = 2.98, p = 0.031). Prevalence of depression over the 12-month period was 8.0% and 3.5% for controls and HeadGear recipients, respectively, with odds of depression caseness amongst the intervention group of 0.43 (p = 0.001, 95% CI 0.26-0.70). CONCLUSIONS: This trial demonstrates that a smartphone app can reduce depression symptoms and potentially prevent incident depression caseness and such interventions may have a role in improving working population mental health. Some caution in interpretation is needed regarding the clinical significance due to small effect size and trial attrition.Trial Registration Australian and New Zealand Clinical Trials Registry (www.anzctr.org.au/) ACTRN12617000548336.
背景:有证据表明,抑郁症是可以预防的;然而,传统方法面临着严重的可扩展性问题。数字技术提供了一种潜在的解决方案,尽管这尚未得到充分验证。本研究旨在评估一款新的智能手机应用程序在大量澳大利亚工作者中降低抑郁症状和随后发生抑郁的效果。
方法:采用随机对照试验,在基线后 5 周和 3 个月、12 个月进行随访评估。参与者为报告无临床显著抑郁的澳大利亚在职人员。干预组(N=1128)被分配使用 HeadGear,这是一款智能手机应用程序,包括为期 30 天的行为激活和正念干预。对照组(N=1143)使用一款包括 30 天情绪监测组件的应用程序。主要结局是 3 个月随访时的抑郁症状水平(PHQ-9)。分析采用混合模型,在意向治疗框架内进行。
结果:与对照组相比,分配到 HeadGear 组的参与者在试验过程中抑郁症状较少(F3,734.7=2.98,p=0.031)。在 12 个月期间,对照组和 HeadGear 组的抑郁发生率分别为 8.0%和 3.5%,干预组的抑郁发生率为 0.43(p=0.001,95%CI 0.26-0.70)。
结论:本试验表明,智能手机应用程序可以降低抑郁症状,可能预防新发抑郁病例,此类干预措施可能在改善工作人群心理健康方面发挥作用。由于效果小且试验失访,需要谨慎解释临床意义。
试验注册澳大利亚和新西兰临床试验注册中心(www.anzctr.org.au/)ACTRN12617000548336。
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