Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.
Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.
J Med Internet Res. 2022 Mar 9;24(3):e28942. doi: 10.2196/28942.
Suboptimal understanding of depression and mental health disorders by the general population is an important contributor to the wide treatment gap in depression. Mental health literacy encompasses knowledge and beliefs about mental disorders and supports their recognition, management, and prevention. Besides knowledge improvement, psychoeducational interventions reduce symptoms of depression, enhance help-seeking behavior, and decrease stigma. Mental health apps often offer educational content, but the trustworthiness of the included information is unclear.
The aim of this study is to systematically evaluate adherence to clinical guidelines on depression of the information offered by mental health apps available in major commercial app stores.
A systematic assessment of the educational content regarding depression in the apps available in the Apple App Store and Google Play was conducted in July 2020. A systematic search for apps published or updated since January 2019 was performed using 42matters. Apps meeting the inclusion criteria were downloaded and assessed using two smartphones: an iPhone 7 (iOS version 14.0.1) and a Sony XPERIA XZs (Android version 8.0.0). The 156-question assessment checklist comprised general characteristics of apps, appraisal of 38 educational topics and their adherence to evidence-based clinical guidelines, as well as technical aspects and quality assurance. The results were tabulated and reported as a narrative review, using descriptive statistics.
The app search retrieved 2218 apps, of which 58 were included in the analysis (Android apps: n=29, 50%; iOS apps: n=29, 50%). Of the 58 included apps, 37 (64%) apps offered educational content within a more comprehensive depression or mental health management app. Moreover, 21% (12/58) of apps provided non-evidence-based information. Furthermore, 88% (51/58) of apps included up to 20 of the educational topics, the common ones being listing the symptoms of depression (52/58, 90%) and available treatments (48/58, 83%), particularly psychotherapy. Depression-associated stigma was mentioned by 38% (22/58) of the apps, whereas suicide risk was mentioned by 71% (41/58), generally as an item in a list of symptoms. Of the 58 included apps, 44 (76%) highlighted the importance of help seeking, 29 (50%) emphasized the importance of involving the user's support network. In addition, 52% (30/58) of apps referenced their content, and 17% (10/58) included advertisements.
Information in mental health and depression apps is often brief and incomplete, with 1 in 5 apps providing non-evidence-based information. Given the unmet needs and stigma associated with the disease, it is imperative that apps seize the opportunity to offer quality, evidence-based education or point the users to relevant resources. A multistakeholder consensus on a more stringent development and publication process for mental health apps is essential.
普通人群对抑郁和精神障碍的理解不足，是导致抑郁治疗缺口较大的一个重要因素。精神卫生素养包括对精神障碍的认识和信念，并支持对其的识别、管理和预防。除了知识的提高，心理教育干预可以减轻抑郁症状，增强寻求帮助的行为，并减少耻辱感。精神健康应用程序通常提供教育内容，但其中信息的可信度尚不清楚。
本研究旨在系统评估主要商业应用商店中提供的精神健康应用程序中关于抑郁的信息是否符合临床指南。
在 2020 年 7 月，对苹果应用商店和谷歌应用商店中关于抑郁的教育内容进行了系统评估。使用 42matters 对自 2019 年 1 月以来发布或更新的应用程序进行了系统搜索。符合纳入标准的应用程序通过两部智能手机进行下载和评估：一部是 iPhone 7（iOS 版本 14.0.1）和一部索尼 XPERIA XZs（Android 版本 8.0.0）。156 个问题的评估检查表包括应用程序的一般特征、38 个教育主题及其对循证临床指南的评估，以及技术方面和质量保证。结果以叙述性综述的形式进行总结和报告，使用描述性统计。
应用程序搜索共检索到 2218 个应用程序，其中 58 个被纳入分析（安卓应用程序：n=29，50%；苹果应用程序：n=29，50%）。在纳入的 58 个应用程序中，37 个（64%）应用程序在更全面的抑郁或精神健康管理应用程序中提供了教育内容。此外，21%（12/58）的应用程序提供了非循证信息。此外，88%（51/58）的应用程序包括了多达 20 个教育主题，常见的主题包括列出抑郁症状（52/58，90%）和可用的治疗方法（48/58，83%），特别是心理治疗。38%（22/58）的应用程序提到了与抑郁相关的耻辱感，而 71%（41/58）的应用程序提到了自杀风险，通常是作为症状列表中的一个项目。在纳入的 58 个应用程序中，44%（29/58）强调了寻求帮助的重要性，29%（17/58）强调了让用户的支持网络参与的重要性。此外，52%（30/58）的应用程序引用了他们的内容，17%（10/58）包含广告。
精神健康和抑郁应用程序中的信息往往简短且不完整，五分之一的应用程序提供非循证信息。鉴于与该疾病相关的未满足需求和耻辱感，应用程序必须抓住机会提供高质量、循证的教育，或为用户提供相关资源。多利益相关者就更严格的精神健康应用程序开发和发布流程达成共识是至关重要的。
