Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 12, 2019
Date Accepted: Apr 26, 2020
The Effectiveness of a Mobile App Intervention for Anxiety and Depression Symptoms in University Students: a Randomised Controlled Trial
ABSTRACT
Background:
Depression and anxiety symptoms are common among university students, but many do not receive treatment. This is due to lack of availability, reluctance to seek help and many students not meeting the diagnostic criteria required to access services. Internet-based interventions such as smartphone applications can overcome these issues, but there are a large number available and little evidence of their effectiveness.
Objective:
To evaluate for the first time the effectiveness of a self-guided mobile app, “Feel Stress Free”, for the treatment of depression and anxiety symptoms in students.
Methods:
A web-based randomised controlled trial (RCT) compared a cognitive behavioural therapy-based mobile app “Feel Stress Free” with a wait list control. University students self-identified as experiencing symptoms of anxiety and/or depression, and were randomised to intervention (n=84) or control (n=84), unblinded. The app is self-guided and incorporates behavioural relaxation activities, mood tracking and thought challenging, and mini-games. Participants completed the Hospital Anxiety and Depression Scale (HADS) online at baseline and fortnightly for six weeks.
Results:
At Week 6, the primary endpoint, there was evidence that the “Feel Stress Free” app reduced depression symptoms (mean difference: -1.56; 95% CI: -2.67 to -0.44; P = .006), but only very weak evidence that it reduced anxiety symptoms (mean difference: -1.36; 95% CI: -2.93 to 0.21; P = .09). At Week 4, there was evidence to support the effectiveness of the intervention for anxiety symptoms (mean difference: -1.94; 95% CI: -3.11 to -0.77; P = .001) and, though weaker, depression symptoms (mean difference: -1.08; 95% CI: -2.12 to -0.04; P = .04). At Week 6, 83% of participants indicated that they were using the app weekly or more.
Conclusions:
The “Feel Stress Free” app is a promising mobile intervention for treating symptoms of anxiety and depression in students, and overcomes many of the barriers to traditional CBT. Further research is needed to establish its long-term effectiveness. Clinical Trial: ClinicalTrials.gov NCT03032952
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