Toward the Design of Evidence-Based Mental Health Information Systems for People With Depression: A Systematic Literature Review and Meta-Analysis

Abstract

BackgroundExisting research postulates a variety of components that show an impact on utilization of technology-mediated mental health information systems (MHIS) and treatment outcome. Although researchers assessed the effect of isolated design elements on the results of Web-based interventions and the associations between symptom reduction and use of components across computer and mobile phone platforms, there remains uncertainty with regard to which components of technology-mediated interventions for mental health exert the greatest therapeutic gain. Until now, no studies have presented results on the therapeutic benefit associated with specific service components of technology-mediated MHIS for depression.ObjectiveThis systematic review aims at identifying components of technology-mediated MHIS for patients with depression. Consequently, all randomized controlled trials comparing technology-mediated treatments for depression to either waiting-list control, treatment as usual, or any other form of treatment for depression were reviewed. Updating prior reviews, this study aims to (1) assess the effectiveness of technology-supported interventions for the treatment of depression and (2) add to the debate on what components in technology-mediated MHIS for the treatment of depression should be standard of care.MethodsSystematic searches in MEDLINE, PsycINFO, and the Cochrane Library were conducted. Effect sizes for each comparison between a technology-enabled intervention and a control condition were computed using the standard mean difference (SMD). Chi-square tests were used to test for heterogeneity. Using subgroup analysis, potential sources of heterogeneity were analyzed. Publication bias was examined using visual inspection of funnel plots and Begg’s test. Qualitative data analysis was also used. In an explorative approach, a list of relevant components was extracted from the body of literature by consensus between two researchers.ResultsOf 6387 studies initially identified, 45 met all inclusion criteria. Programs analyzed showed a significant trend toward reduced depressive symptoms (SMD –0.58, 95% CI –0.71 to –0.45, P<.001). Heterogeneity was large (I2≥76). A total of 15 components were identified.ConclusionsTechnology-mediated MHIS for the treatment of depression has a consistent positive overall effect compared to controls. A total of 15 components have been identified. Further studies are needed to quantify the impact of individual components on treatment effects and to identify further components that are relevant for the design of future technology-mediated interventions for the treatment of depression and other mental disorders.

Exploring User Needs for a Mobile Behavioral-Sensing Technology for Depression Management: Qualitative Study

“…In addition, mobile technologies have been shown to have advantages in delivering mental health therapies [13,14]. Systematic reviews have summarized the therapeutic effects of technology mediated mental health information systems [15]. For example, mental health apps on mobile phones could improve the accessibility to treatment and facilitate proactive seeking for professional help [13,16].…”

Terapia cognitiva con entrega virtual en trastorno depresivo persistente: estudio de caso

“…En este orden de ideas, respecto a la estabilización del ánimo y la reducción de síntomas físicos, se observó que la paciente al finalizar el tratamiento y en el seguimiento, reportó un estado de ánimo estable, y planteó que no le aquejaban síntomas físicos, en relación con su motivo de consulta, lo cual se evidenciaba en su último examen del estado mental. Conviene subrayar, por tanto, que la TCC con entrega por internet es eficaz para reducir significativamente los síntomas de depresión, según resultados del BDI-II o PHQ-9 (Linde et al,2015;Wahle, . et al, 2017).…”

Exploring User Needs for a Mobile Behavioral-Sensing Technology for Depression Management: Qualitative Study (Preprint)

“…In addition to behavioral indicators of people's mental health status, mobile technologies have the advantages in delivering mental health care and therapies [13,14,15]. Systematic reviews have summarized therapeutic effects of technology mediated mental health information systems [16]. For example, reviews of the efficacy of mental health apps on mobile devices reported that mobile health apps had the potential to improve accessibility to seek treatment [17,19].…”