Smartphone App Reduces Symptoms in Users With Serious Mental Illness

A smartphone app designed to challenge dysfunctional beliefs in people with serious mental illness reduced symptoms of depression and anxiety as well as functional impairment, according to a study published in the Journal of Medical Internet Research.

“This was the first fully remote randomized controlled trial testing a digital intervention for severe mental illness,” said study lead author Dror Ben-Zeev, PhD, professor of psychiatry at the University of Washington School of Medicine in Seattle. “The intervention proved to be very effective in reducing their symptoms and improving recovery. This is very encouraging.”

The app, called CORE, features onscreen statements about the user, the world, and the future. Users can swipe statements toward themselves or discard them. If they pull a dysfunctional statement toward themselves, the app draws attention to the unhealthy thought and encourages users to adopt a healthier alternative. The app aims to help users lean into healthier statements and integrate them into their self-talk.

For the study, researchers recruited 315 participants with self-reported serious mental illness in 45 states through online ads on Google and Facebook. Among them, 111 reported bipolar disorder, 136 reported major depressive disorder, and 68 reported schizophrenia or schizoaffective disorder. Participants were assessed by a clinician using various screening tools and, afterward, were randomly assigned to an active intervention group or a waitlist control group. The active intervention consisted of using the CORE app 3 minutes a day over 30 days.

After the intervention, app users averaged a 7-point decrease on the Beck Depression Inventory, a 4-point drop on the Generalized Anxiety Disorder-7 scale, and a 5-point reduction on the Sheehan Disability Scale, according to the study. Additionally, app users averaged a 3-point increase on the Rosenberg Self-Esteem Scale and an 11-point jump on the Recovery Assessment Scale.

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The changes did not occur in the waitlist control group, researchers added. What’s more, improvements were maintained in the intervention group at a 60-day assessment, whether or not people still used the app.

“Rapid adoption and real-world dissemination of evidence-based mobile health interventions such as CORE are needed if we are to shorten the science-to-service gap,” researchers wrote, “and address the significant unmet mental health needs of people with serious mental illness during the COVID-19 pandemic and beyond.”

References

Ben-Zeev D, Chander A, Tauscher J, et al. A smartphone intervention for people with serious mental illness: fully remote randomized controlled trial of CORE. J Med Internet Res. 2021;23(11):e29201.

Serious mental illness? There’s an app for that. News release. University of Washington School of Medicine/UW Medicine; November 15, 2021. Accessed November 22, 2021.