A digital app based on behavioral activation—which involves engaging individuals in rewarding activities to offset negative mood—is effective at reducing depressive symptoms among adults receiving primary care, according to a clinical trial published today in JAMA Internal Medicine.
“Expanding the behavioral health workforce is unlikely to meet the mental health needs of all adults treated in the primary care setting,” wrote Jennifer Dahne, Ph.D., of the Medical University of South Carolina, and colleagues. “However, expanding the workforce could be complemented with self-guided digital mental health interventions … [that] give patients on-demand access with the ability to self-select the frequency and duration of sessions.”
The app used in this trial was Moodivate, which enables users to set goals across certain life areas as well as measurable activities to reach a goal; for example, under a goal of building relationships, users could task themselves to go out to dinner with a friend once a week. Gamification elements such as badges are included to promote long-term engagement with Moodivate.
Dahne and colleagues randomized 649 adults with at least moderate depression from primary care/family medicine clinics across South Carolina to receive Moodivate (n=437) or continue with their usual care (n=212) for 12 weeks. The adults who had Moodivate were further randomized into those who had the regular app or who had an app linked to their electronic health record (EHR), which allowed their doctors to review a patient’s engagement and progress. Depression symptoms were assessed with the Beck Depression Inventory II (BDI-II) every week for the first eight weeks and then again at week 12.
At baseline, average BDI-II scores were around 33 for all adults. After 12 weeks, BDI-II scores dropped by 10.3 points for adults using Moodivate, 9.88 points for adults with Moodivate-EHR, and 5.94 points for adults receiving usual care. Adults in both Moodivate groups were also more than twice as likely to achieve depression remission than those receiving usual care. Participant engagement was 100% during the first week and 33% by week 12. However, only 14% of these adults’ physicians with access used the EHR functionality, but the researchers were encouraged that physician engagement was not crucial for improving depression.
“Although Moodivate needs further testing in other clinical settings and at scale, this self-guided digital behavioral activation intervention may provide an accessible and valuable depression treatment option,” they concluded.
For related information, see the Psychiatric News articles “Multi-App Package Provides Tailored Behavioral Care” and “Smartphone App Shows Promise in Some Patients With Bipolar I.”
(Image: Getty Images/iStock/FreshSplash)
Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.