The efficacy of mobile mental health applications (mHealth apps) in reducing symptoms of anxious and depressive distress in a university population

Abstract

Internet-based self-help interventions, such as mobile mental health applications (mHealth apps), have the potential to enhance mental health service delivery in universities in a cost-effective way. However, the existing literature on mHealth apps is limited and does not sufficiently support their supposed benefits. The present study attempted to evaluate the efficacy of selfguided mHealth apps in reducing symptoms of psychological anxious distress and psychological depressive distress among university students. Students (N = 77; 76.6% female; 17 to 53 years old) completed the Hospital and Anxiety Depression Scale (HADS) prior to being randomized to 6 weeks of intervention with one of three mHealth apps marketed for reducing anxiety (DARE, Mindshift, or Stresscoach), or an active smartphone-based control to rule out the digital placebo effect (Coloring Book for Adults app). After 6 weeks, students completed the HADS again as a follow-up measure of app effectiveness. The results did not support the effectiveness of the mHealth apps in reducing anxious or depressive distress (Pillai’s Trace = .024, F(6, 146) = .290, p = .941). However, the results suggested that over time, students’ levels of depression increased, irrespective of app (mean difference = -.698; 95% CI = -1.364 to -0.33). The results also suggested that students with problematic levels of anxious distress at baseline experienced a decrease in symptoms at follow-up, irrespective of app (mean difference = 1.696; 95% CI = .816 to 2.575). Conversely, students who did not report anxious distress at baseline experienced an increase in anxious distress at follow-up, regardless of app (mean difference = -1.806; 95% CI = -2.878 to -.735).