BACKGROUND Anxiety and depression symptoms are a significant mental health challenge for women in the reproductive age and midlife. Cognitive behavioral therapy (CBT) based mobile health (mHealth) interventions may be a viable solution for addressing the treatment gap for women at these ages. OBJECTIVE The aim of this study is to analyze the real world data of ‘OCD.app - Anxiety, Mood & Sleep’, a mobile app with brief CBT-based daily exercises targeting maladaptive beliefs in multiple domains. In this study we focused on modules targeting anxiety and depression related cognitions. METHODS We collected real world data of women using the CBT based app “OCD.app - Anxiety, Mood & Sleep” from October 2020 to January 2023. Women’s levels of anxiety (GAD-7) and depression (PHQ-9) were evaluated prior to the intervention (T0), at the payment barrier (T1), and upon completion of the intervention (T-Final). RESULTS Women’s dropout rates were associated with younger age and more severe symptoms. Large effect-size reductions were found at T1 (n= 1,554; Cohen’s d = 0.702) and T-Final (n=491; Cohen’s d = 0.774) with 37.9% reaching clinically significant improvement in anxiety symptoms (GAD-7 change>4). Similar analyses of women’s PHQ-9 scores indicated small effect-size reductions at T1 (n=512; Cohen’s d = 0.34) and moderate effect-size decreases at T-Final (n=140; Cohen’s d = 0.489) with 23.6% of women reaching clinically significant improvement in depression symptoms (PHQ-9 change>5). CONCLUSIONS Results support the effectiveness of brief CBT-based mHealth interventions for women with depression and anxiety symptoms in real world settings.

Anxiety and depression symptoms are a significant mental health challenge for women in the reproductive age and midlife. Cognitive behavioral therapy (CBT) based mobile health (mHealth) interventions may be a viable solution for addressing the treatment gap for women at these ages. We collected real world data of women using the CBT based app “OCD.app - Anxiety, Mood & Sleep” from October 2020 to January 2023. Women’s levels of anxiety (GAD-7) and depression (PHQ-9) were evaluated prior to the intervention (T0), at the payment barrier (T1), and upon completion of the intervention (T-Final). Women’s dropout rates were associated with younger age and more severe symptoms. Large effect-size reductions were found at T1 (n = 1,554; Cohen’s d = 0.702) and T-Final (n = 491; Cohen’s d = 0.774) with 37.9% reaching clinically significant improvement in anxiety symptoms (GAD-7 change > 4). Similar analyses of women’s PHQ-9 scores indicated small effect-size reductions at T1 (n = 512; Cohen’s d = 0.34) and moderate effect-size decreases at T-Final (n = 140; Cohen’s d = 0.489) with 23.6% of women reaching clinically significant improvement in depression symptoms (PHQ-9 change > 5). Results support the effectiveness of brief CBT-based mHealth interventions for women with depression and anxiety symptoms in real world settings.