JMIR Publications

ABSTRACT

Background:

The prevalence of major depressive disorder (MDD) poses significant global health challenges, with available treatments often insufficient in achieving remission for many patients. Digital health technologies, such as text messaging-based cognitive behavior therapy (CBT), offer accessible alternatives but may not reach all individuals. Email communication presents a secure avenue for health communication, yet its effectiveness compared to text messaging in providing mental health support for MDD patients remains uncertain.

Objective:

This study aims to compare the efficacy of email versus text messaging as delivery platforms for supporting patients with MDD, addressing a critical gap in understanding optimal digital interventions for mental health care.

Methods:

A randomized non-inferiority pilot trial was conducted, comparing outcomes for patients receiving six-week daily supportive messages via email with those receiving messages via text. Participants (N=66) were recruited from the Access 24/7 clinic in Edmonton, Alberta, among those who were diagnosed with MDD. The outcomes were measured at baseline and six months after enrollment using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the World Health Organization Well-Being Index (WHO-5).

Results:

There was no statistically significant difference in the mean changes in PHQ-9, GAD-7, and WHO-5 scores between the email and text messaging groups. Both supportive modalities showed potential in reducing depressive symptoms and improving quality of life.

Conclusions:

The study’s findings suggest that both email and text messaging interventions have equivalent effectiveness in reducing depression symptoms among individuals with MDD. As digital technology continues to evolve, harnessing the power of multiple digital platforms for mental health interventions can significantly contribute to bridging the existing treatment gaps and improving the overall well-being of individuals with depressive conditions. Further research is needed with a larger sample size to confirm and expand upon these findings. Clinical Trial: The study received institutional review board approval from the University of Alberta Human Ethics Review Board (Pro00105429) and the trial was registered at clinicaltrials.gov (NCT04638231).