Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Health and Nursing Science, Berlin, Germany.
Centre for ePublic Health Research, School of Public Health, Bielefeld University, Bielefeld, Germany.
JMIR Mhealth Uhealth. 2021 Feb 10;9(2):e24703. doi: 10.2196/24703.
Depression is often associated with rapid changes in mood and quality of life that persist for a period of 2 weeks. Despite medical innovations, there are problems in the provision of care. Long waiting times for treatment and high recurrence rates of depression cause enormous costs for health care systems. At the same time, comprehensive limitations in physical, psychological, and social dimensions are observed for patients with depression, which significantly reduce their quality of life. In addition to patient-specific limitations, undersupply and inappropriate health care have been determined. For this reason, new forms of care are discussed. Smartphone-based therapy is considered to have great potential due to its reach and easy accessibility. Low socioeconomic groups, which are always difficult to reach for public health interventions, can now be accessed due to the high dispersion of smartphones. There is still little information about the impact and mechanisms of smartphone-based therapy on depression. In a systematic literature review, the health implications of smartphone-based therapy were presented in comparison with standard care.
The objective of this review was to identify and summarize the existing evidence regarding smartphone-based cognitive behavioral therapy for patients with depression and to present the health implications of smartphone-based cognitive behavioral therapy of considered endpoints.
A systematic literature review was conducted to identify relevant studies by means of inclusion and exclusion criteria. For this purpose, the PubMed and Psyndex databases were systematically searched using a search syntax. The endpoints of depressive symptoms, depression-related anxiety, self-efficacy or self-esteem, and quality of life were analyzed. Identified studies were evaluated for study quality and risk of bias. After applying the inclusion and exclusion criteria, 8 studies were identified.
The studies examined in this review reported contradictory results regarding the investigated endpoints. In addition, due to clinical and methodological heterogeneity, it was difficult to derive evident results. All included studies reported effects on depressive symptoms. The other investigated endpoints were only reported by isolated studies. Only 50% (4/8) of the studies reported effects on depression-related anxiety, self-efficacy or self-esteem, and quality of life.
No clear implications of smartphone-based cognitive behavioral therapy could be established. Evidence for the treatment of depression using smartphone-based cognitive behavioral therapy is limited. Additional research projects are needed to demonstrate the effects of smartphone-based cognitive behavioral therapy in the context of evidence-based medicine and to enable its translation into standard care. Participatory technology development might help to address current problems in mobile health intervention studies.
抑郁症常伴有情绪和生活质量的快速变化，持续时间为 2 周。尽管医学创新，但在护理方面仍存在问题。治疗的长时间等待和抑郁症的高复发率给医疗保健系统带来了巨大的成本。与此同时，观察到抑郁症患者在身体、心理和社会维度上存在全面的局限性，这大大降低了他们的生活质量。除了患者特有的局限性外，还确定了供应不足和护理不当的问题。出于这个原因，正在讨论新的护理形式。由于智能手机的普及和易于获取，基于智能手机的治疗被认为具有巨大的潜力。由于智能手机的广泛分布，现在可以接触到总是难以接受公共卫生干预的低社会经济群体。关于基于智能手机的治疗对抑郁症的影响和机制，信息仍然很少。在系统的文献综述中，将基于智能手机的治疗与标准护理进行了比较，介绍了其对健康的影响。
本综述的目的是确定和总结现有关于基于智能手机的认知行为疗法治疗抑郁症患者的证据，并介绍考虑的终点的基于智能手机的认知行为疗法的健康影响。
通过纳入和排除标准，采用搜索语法，通过PubMed 和 Psyndex 数据库系统地搜索相关研究。分析了抑郁症状、与抑郁相关的焦虑、自我效能或自尊以及生活质量等终点。评估了确定的研究的研究质量和偏倚风险。在应用纳入和排除标准后，确定了 8 项研究。
本综述中检查的研究报告了关于研究终点的相互矛盾的结果。此外，由于临床和方法学的异质性，很难得出明显的结果。所有纳入的研究都报告了对抑郁症状的影响。其他研究终点仅由孤立的研究报告。只有 50%（4/8）的研究报告了对与抑郁相关的焦虑、自我效能或自尊和生活质量的影响。
无法确定基于智能手机的认知行为疗法的明确影响。使用基于智能手机的认知行为疗法治疗抑郁症的证据有限。需要开展更多的研究项目，以在循证医学的背景下证明基于智能手机的认知行为疗法的疗效，并将其转化为标准护理。参与式技术开发可能有助于解决移动健康干预研究中的当前问题。
