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Lee CHJ, Bazan M, Wong J, Yoshida T, Jantarabenjakul W, Lin SY, Papatheodorou S. The efficacy of mobile applications for reducing depression in adolescents and young adults: A meta-analysis of randomized control trials. J Telemed Telecare 2024:1357633X241273032. [PMID: 39295471 DOI: 10.1177/1357633x241273032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
BACKGROUND Mobile applications for mental health have the potential to aid people with mental health disorders, especially depression, by providing them with tools and coping mechanisms. Adolescents and young adults, being at risk of depressive symptoms and leading mobile users, are among the main targets of using mobile applications to alleviate symptoms. OBJECTIVE This study aimed to evaluate the impact of mobile application-based psychological interventions in reducing depression symptoms in adolescents and young adults compared to those not exposed to the intervention. METHODS We conducted a meta-analysis focusing on mobile applications for reducing depressive symptoms. We searched two databases: MEDLINE and EMBASE and included randomized controlled trials conducted in English among participants aged 18-35 years old who were assessed for depressive symptoms using a validated screening measure and used mobile applications-based psychological interventions. Two of six independent reviewers conducted study selection, data extraction, and bias assessment. A pooled mean standardized difference (Cohen's d) and 95% CI were calculated using random-effects meta-analysis. Risk of bias was assessed using I2 statistics and forest plot. Egger's test was used for assessing publication bias. RESULTS After screening 740 references, we identified 12 trials with 1869 participants, with a mean age of participants ranging from 14.70 to 25.1 years. The interventions ranged from cognitive behavioral therapy (CBT)-based mobile apps to interactive story-telling apps and apps delivering a mix of CBT, interpersonal psychotherapy for adolescents, and dialectical behavior therapy elements. Control groups included information-only, waitlist, no intervention, and treatment as usual. Seven studies used Patient Health Questionnaire-9 (PHQ-9) to assess the severity of depressive symptoms, while the other five used different scales. There was no evidence of publication bias (p = 0.325). The mobile applications reduced depression score by 0.08 units of standardized difference more than the control, with a 95% CI of -0.19 to 0.03 (p = 0.294, I2 = 15.4%) using standardized mean difference (SMD) as the effect estimate. In a sensitivity analysis including only studies that used PHQ-9, we found a similar trend, SMD -0.72 (95%CI -1.48 to 0.03). However, both findings were not significant. CONCLUSIONS Current evidence is insufficient to support mobile applications to relieve depression symptoms in adolescents and young adults. Further trials with larger sample size are needed to confirm our findings of a positive trend. With emerging technologies and the high exposure of apps in this population, mobile applications for depression hold promise for the future of treatment and awareness of mental health disorders in this population.
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Affiliation(s)
- Ching-Hua Julie Lee
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maria Bazan
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Universidad Científica del Sur, Lima, Peru
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jolene Wong
- Division of Surgery & Surgical Oncology, National Cancer Centre Singapore & Singapore General Hospital, Singapore, Singapore
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Takuto Yoshida
- Surgical Artificial Intelligence Research Academy, University Health Network, Toronto, Ontario, Canada
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Watsamon Jantarabenjakul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sheng-Yi Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stefania Papatheodorou
- Rutgers School of Public Health, Piscataway, NJ, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ahmed S, Trimmer C, Khan W, Tuck A, Rodak T, Agic B, Kavic K, Wadhawan S, Abbott M, Husain MO, Husain MI, McKenzie K, Quintana Y, Naeem F. A mixed methods analysis of existing assessment and evaluation tools (AETs) for mental health applications. Front Public Health 2024; 12:1196491. [PMID: 38774052 PMCID: PMC11106355 DOI: 10.3389/fpubh.2024.1196491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/17/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction Mental health Applications (MH Apps) can potentially improve access to high-quality mental health care. However, the recent rapid expansion of MH Apps has created growing concern regarding their safety and effectiveness, leading to the development of AETs (Assessment and Evaluation Tools) to help guide users. This article provides a critical, mixed methods analysis of existing AETs for MH Apps by reviewing the criteria used to evaluate MH Apps and assessing their effectiveness as evaluation tools. Methods To identify relevant AETs, gray and scholarly literature were located through stakeholder consultation, Internet searching via Google and a literature search of bibliographic databases Medline, APA PsycInfo, and LISTA. Materials in English that provided a tool or method to evaluate MH Apps and were published from January 1, 2000, to January 26, 2021 were considered for inclusion. Results Thirteen relevant AETs targeted for MH Apps met the inclusion criteria. The qualitative analysis of AETs and their evaluation criteria revealed that despite purporting to focus on MH Apps, the included AETs did not contain criteria that made them more specific to MH Apps than general health applications. There appeared to be very little agreed-upon terminology in this field, and the focus of selection criteria in AETs is often IT-related, with a lesser focus on clinical issues, equity, and scientific evidence. The quality of AETs was quantitatively assessed using the AGREE II, a standardized tool for evaluating assessment guidelines. Three out of 13 AETs were deemed 'recommended' using the AGREE II. Discussion There is a need for further improvements to existing AETs. To realize the full potential of MH Apps and reduce stakeholders' concerns, AETs must be developed within the current laws and governmental health policies, be specific to mental health, be feasible to implement and be supported by rigorous research methodology, medical education, and public awareness.
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Affiliation(s)
- Sarah Ahmed
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Chris Trimmer
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Wishah Khan
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Andrew Tuck
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Kelsey Kavic
- Mental Health Commission of Canada, Ottawa, ON, Canada
| | | | | | - M. Omair Husain
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - M. Ishrat Husain
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Kwame McKenzie
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yuri Quintana
- Harvard Medical School, Harvard University, Boston, MA, United States
- Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Farooq Naeem
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Cho CH, Lee HJ, Kim YK. Telepsychiatry in the Treatment of Major Depressive Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1456:333-356. [PMID: 39261437 DOI: 10.1007/978-981-97-4402-2_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
This chapter explores the transformative role of telepsychiatry in managing major depressive disorders (MDD). Traversing geographical barriers and reducing stigma, this innovative branch of telemedicine leverages digital platforms to deliver effective psychiatric care. We investigate the evolution of telepsychiatry, examining its diverse interventions such as videoconferencing-based psychotherapy, medication management, and mobile applications. While offering significant advantages like increased accessibility, cost-effectiveness, and improved patient engagement, challenges in telepsychiatry include technological barriers, privacy concerns, ethical and legal considerations, and digital literacy gaps. Looking forward, emerging technologies like virtual reality, artificial intelligence, and precision medicine hold immense potential to personalize and enhance treatment effectiveness. Recognizing its limitations and advocating for equitable access, this chapter underscores telepsychiatry's power to revolutionize MDD treatment, making quality mental healthcare a reality for all.
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Affiliation(s)
- Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
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Miller I, Peake E, Strauss G, Vierra E, Koepsell X, Shalchi B, Padmanabhan A, Lake J. Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study. JMIR Form Res 2023; 7:e43260. [PMID: 37991839 DOI: 10.2196/43260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 06/21/2023] [Accepted: 07/25/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Depression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliver components of cognitive behavioral therapy (CBT) have been shown to reduce symptoms of depression, and virtual reality (VR) may be a promising adjunctive component. However, research on these types of treatments in adolescents and young adults is limited. OBJECTIVE This study aims to evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0), a 5-week, self-guided, CBT-based digital program using a mobile app and VR experiences to target symptoms of depression in adolescents. METHODS A single-arm, open-label study of the Spark program was conducted with a community sample of 30 adolescents and young adults aged 12 to 21 years with self-reported moderate to severe depression symptoms. Participants completed a weekly depression assessment (Patient Health Questionnaire-8) in the app during the 5-week intervention period as well as web-based baseline, postintervention, and 1-month follow-up self-report assessments. The participants also completed a qualitative postintervention interview. For participants aged <18 years, caregivers completed assessments at baseline and postintervention time points. Feasibility outcomes included recruitment rate (the proportion of participants who enrolled in the study divided by the total number of participants screened for eligibility) and retention rate (the proportion of participants who completed postintervention assessments divided by the total number of participants who received the intervention). Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Preliminary efficacy was evaluated based on the Patient Health Questionnaire-8. RESULTS The study recruitment (31/66, 47%) and retention (29/30, 97%) rates were high. Participants provided higher ratings for the ease of use of the Spark program (8.76 out of 10) and their enjoyment of both the mobile app (7.00 out of 10) and VR components (7.48 out of 10) of the program, whereas they provided lower ratings for the program's ability to improve mood (4.38 out of 10) or fit into their daily routines (5.69 out of 10). We observed a clinically and statistically significant reduction in depression scores at postintervention (mean difference 5.36; P<.001) and 1-month follow-up (mean difference 6.44; P<.001) time points. CONCLUSIONS The Spark program was found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents and young adults with symptoms of depression. Preliminary data also indicated that the Spark program reduced the symptoms of depression in adolescents and young adults. Future studies should evaluate the efficacy of this intervention in an adequately powered randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04165681; https://classic.clinicaltrials.gov/ct2/show/NCT04165681.
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Affiliation(s)
- Ian Miller
- Limbix Health, Inc, San Francisco, CA, United States
| | - Emily Peake
- Limbix Health, Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
| | | | - Elise Vierra
- Limbix Health, Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
| | - Xin Koepsell
- Limbix Health, Inc, San Francisco, CA, United States
| | | | - Aarthi Padmanabhan
- Limbix Health, Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
| | - Jessica Lake
- Limbix Health, Inc, San Francisco, CA, United States
- Big Health Inc, San Francisco, CA, United States
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Shania M, Handayani PW, Asih S. Designing High-Fidelity Mobile Health for Depression in Indonesian Adolescents Using Design Science Research: Mixed Method Approaches. JMIR Form Res 2023; 7:e48913. [PMID: 37399059 PMCID: PMC10365601 DOI: 10.2196/48913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND COVID-19 mitigation protocols, enacted to control the pandemic, have also been shown to have a negative impact on mental health, including the mental health of adolescents. The threat of being infected by SARS-CoV-2 and substantial changes in lifestyle, including limited social interaction due to stay-at-home orders, led to loneliness as well as depressive symptoms. However, offline psychological assistance is restricted, as psychologists are bounded by mitigation protocols. Further, not all adolescents' guardians are open to their children attending or have the means to pay for psychological service; thus, adolescents remain untreated. Having a mobile health (mHealth) app for mental health that uses monitoring, provides social networks, and delivers psychoeducation may provide a solution, especially in countries that have limited health facilities and mental health workers. OBJECTIVE This study aimed to design an mHealth app to help prevent and monitor depression in adolescents. The design of this mHealth app was carried out as a high-fidelity prototype. METHODS We used a design science research (DSR) methodology with 3 iterations and 8 golden rule guidelines. The first iteration used interviews, and the second and third iterations used mixed method approaches. The DSR stages include the following: (1) identify the problem; (2) define the solution; (3) define the solution objective; (4) develop, demonstrate, and evaluate the solution; and (5) communicate the solution. This study involved students and medical experts. RESULTS The first iteration resulted in a wireframe and prototype for the next iteration. The second iteration resulted in a System Usability Scale score of 67.27, indicating a good fit. In the third iteration, the system usefulness, information quality, interface quality, and overall values were 2.416, 2.341, 2.597, and 2.261, respectively, indicating a good design. Key features of this mHealth app include a mood tracker, community, activity target, and meditation, and supporting features that complement the design include education articles and early detection features. CONCLUSIONS Our findings provide guidance for health facilities and to design and implement future mHealth apps to help treat adolescent depression.
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Affiliation(s)
- Mila Shania
- Faculty of Psychology, University of Indonesia, Depok, Indonesia
| | | | - Sali Asih
- Faculty of Psychology, University of Indonesia, Depok, Indonesia
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The Development and Usability of a Mobile App for Parents of Children with ADHD. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010164. [PMID: 36670714 PMCID: PMC9857426 DOI: 10.3390/children10010164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. METHODS We conducted a study to investigate parents' perceived usability of the ADHD Coping Card. RESULTS The mobile app developed has a high usability. Future improvements in the app were suggested by parents. CONCLUSIONS Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems.
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7
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Can Translational Social Neuroscience Research Offer Insights to Mitigate Structural Racism in the United States? BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1258-1267. [PMID: 35609781 DOI: 10.1016/j.bpsc.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/15/2022] [Accepted: 05/05/2022] [Indexed: 12/16/2022]
Abstract
Social isolation and conflict due to structural racism may result in human suffering and loneliness across the life span. Given the rising prevalence of these problems in the United States, combined with disruptions experienced during the COVID-19 pandemic, the neurobiology of affiliative behaviors may offer practical solutions to the pressing challenges associated with structural racism. Controlled experiments across species demonstrate that social connections are critical to survival, although strengthening individual resilience is insufficient to address the magnitude and impact of structural racism. In contrast, the multilevel construct of social resilience, defined by the power of groups to cultivate, engage in, and sustain positive relationships that endure and recuperate from social adversities, offers unique insights that may have greater impact, reach, and durability than individual-level interventions. Here, we review putative social resilience-enhancing interventions and, when available, their biological mediators, with the hope to stimulate discovery of novel approaches to mitigate structural racism. We first explore the social neuroscience principles underlying psychotherapy and other psychiatric interventions. Then, we explore translational efforts across species to tailor treatments that increase social resilience, with context and cultural sensitivity in mind. Finally, we conclude with some practical future directions for understudied areas that may be essential for progress in biological psychiatry, including ethical ways to increase representation in research and developing social paradigms that inform dynamics toward or away from socially resilient outcomes.
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Bantjes J. Digital solutions to promote adolescent mental health: Opportunities and challenges for research and practice. PLoS Med 2022; 19:e1004008. [PMID: 35639740 PMCID: PMC9154099 DOI: 10.1371/journal.pmed.1004008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Jason Bantjes discusses the accompanying study by Michelle Torok, Jin Han, and colleagues investigating the effects of a self-guided smartphone application on suicidal ideation among young adults.
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Affiliation(s)
- Jason Bantjes
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa
- * E-mail:
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Păsărelu CR, Andersson G, Dobrean A. Attention-deficit/ hyperactivity disorder mobile apps: A systematic review. Int J Med Inform 2020; 138:104133. [DOI: 10.1016/j.ijmedinf.2020.104133] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 02/23/2020] [Accepted: 03/23/2020] [Indexed: 12/25/2022]
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Abstract
BACKGROUND Although apps are increasingly being used to support the diagnosis, treatment and management of mental illness, there is no single means through which costs associated with mental apps are being reimbursed. Furthermore, different apps are amenable to different means of reimbursement as not all apps generate value in the same way. AIMS To provide insights into how apps are currently generating value and being reimbursed across the world, with a particular focus on the situation in the USA. METHOD An international team performed secondary research on how apps are being used and on common pathways to remuneration. RESULTS The uses of apps today and in the future are reviewed, the nature of the value delivered by apps is summarised and an overview of app reimbursement in the USA and other countries is provided. Recommendations regarding how payments might be made for apps in the future are discussed. CONCLUSIONS Currently, apps are being reimbursed through channels with other original purposes. There may be a need to develop an app-specific channel for reimbursement which is analogous to the channels used for devices, drugs and laboratory tests.
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Affiliation(s)
| | - John B Torous
- Director, Digital Psychiatry Division, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Joseph Firth
- Senior Research Fellow, NICM Health Research Institute, Western Sydney University, Australia; and Honorary Research Fellow, Division of Psychology and Mental Health, Faculty of Biology Medicine and Health, University of Manchester, UK
| | - Kenneth R Kaufman
- Professor of Psychiatry, Neurology, and Anaesthesiology, Rutgers Robert Wood Johnson Medical School, USA; and Visiting Professor of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Hilty DM, Uno J, Chan S, Torous J, Boland RJ. Role of Technology in Faculty Development in Psychiatry. Psychiatr Clin North Am 2019; 42:493-512. [PMID: 31358128 DOI: 10.1016/j.psc.2019.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinicians, interprofessional teams, organizational systems, and patients increasingly use technology for health and health care, communication, networking, and business. In this era of ubiquitous connectivity, the digital age has solidified the role of technology in continuing medical education, faculty development, and integrating professional and personal roles and identities. Clinicians are shifting from treating technology as a supplemental modality to using it as a central organizing and facilitating tool, particularly important for clinical care. This is known as an information technology-business-medicine understanding or conceptual framework.
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Affiliation(s)
- Donald M Hilty
- Mental Health, Northern California Veterans Administration Health Care System, Department of Psychiatry and Behavioral Sciences, University of California Davis, 10535 Hospital Way, Mather, CA 95655, USA.
| | - Jessica Uno
- Psychiatry, Kaweah Delta Health Care District, 400 West Mineral King Avenue, Visalia, CA 93291, USA
| | - Steven Chan
- Addiction Treatment Services, Veterans Affairs Palo Alto Health Care System, University of California, San Francisco, 3801 Miranda Avenue, Building 520F, Mail Code 116A, Palo Alto, CA 94304, USA
| | - John Torous
- Digital Psychiatry Division, Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115, USA
| | - Robert J Boland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA
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Mahmoud H, Vogt EL, Sers M, Fattal O, Ballout S. Overcoming Barriers to Larger-Scale Adoption of Telepsychiatry. Psychiatr Ann 2019. [DOI: 10.3928/00485713-20181228-02] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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13
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Van Dam L, Rietstra S, Van der Drift E, Stams GJJM, Van der Mei R, Mahfoud M, Popma A, Schlossberg E, Pentland A, Reid TG. Can an Emoji a Day Keep the Doctor Away? An Explorative Mixed-Methods Feasibility Study to Develop a Self-Help App for Youth With Mental Health Problems. Front Psychiatry 2019; 10:593. [PMID: 31507464 PMCID: PMC6716472 DOI: 10.3389/fpsyt.2019.00593] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Abstract
Today's smartphones allow for a wide range of "big data" measurement, for example, ecological momentary assessment (EMA), whereby behaviours are repeatedly assessed within a person's natural environment. With this type of data, we can better understand - and predict - risk for behavioral and health issues and opportunities for (self-monitoring) interventions. In this mixed-methods feasibility study, through convenience sampling we collected data from 32 participants (aged 16-24) over a period of three months. To gain more insight into the app experiences of youth with mental health problems, we interviewed a subsample of 10 adolescents who received psycthological treatment. The results from this feasibility study indicate that emojis) can be used to identify positive and negative feelings, and individual pattern analyses of emojis may be useful for clinical purposes. While adolescents receiving mental health care are positive about future applications, these findings also highlight some caveats, such as possible drawback of inaccurate representation and incorrect predictions of emotional states. Therefore, at this stage, the app should always be combined with professional counseling. Results from this small pilot study warrant replication with studies of substantially larger sample size.
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Affiliation(s)
- Levi Van Dam
- Spirit Youth Care Amsterdam, Amsterdam, Netherlands.,Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Sianne Rietstra
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | | | - Geert Jan J M Stams
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | | | - Maria Mahfoud
- Centrum Wiskunde and Informatica, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Amsterdam UMC/De Bascule, Amsterdam, Netherlands.,Institute for Criminal Law and Criminology, Leiden University, Leiden, Netherlands
| | - Eric Schlossberg
- Connection Science, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Alex Pentland
- Connection Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Todd G Reid
- Connection Science, Massachusetts Institute of Technology, Cambridge, MA, United States.,Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States.,Harvard T. H. Chan School of Public Health, Boston, MA, United States
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Kern A, Hong V, Song J, Lipson SK, Eisenberg D. Mental health apps in a college setting: openness, usage, and attitudes. Mhealth 2018; 4:20. [PMID: 30050916 PMCID: PMC6043844 DOI: 10.21037/mhealth.2018.06.01] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/17/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The ubiquity of smartphones and the development of mental health apps (MHAs) calls for evaluation of consumers' attitudes towards and usage of MHAs. Due to the increasing demand for mental health services on college campuses, research is especially needed to evaluate MHAs as a potentially viable treatment modality in that setting. METHODS The study team developed survey questions related to MHAs, added these to the Healthy Minds Study, and used Qualtrics as the platform. The participants were 741 students, age 18 and older, from a large Midwest public university. Students could answer a varying number of multiple choice questions based on embedded display logic, and the survey required 20-25 minutes for most participants to complete. Based on embedded display logic in the survey and how questions were answered, students could receive anywhere from 1-20 questions. Questions were primarily categorical (e.g., "Yes", "Maybe", "No"), with the remaining questions in free response format. The survey was fielded in April, 2016. RESULTS 26.1% of respondents were open to using an MHA yet only 7.3% had used an MHA. 9.0% of respondents preferred to use an MHA versus seeing a mental health professional. 13.2% of respondents felt that MHAs do have an evidence base. 23.8% of users felt that MHAs helped with their mental health. Those who reported receiving mental health services within the past 12 months were significantly more open to using MHAs than those who had not received services. Convenience, immediate availability, and confidentiality were common reasons for interest in MHAs. CONCLUSIONS There is interest in, but limited usage, of MHAs among university students, providing evidence of MHAs as a potentially untapped treatment modality for this population. Further research could help assess how best to integrate this technology into the university and college mental health system.
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Affiliation(s)
- Adam Kern
- Washington University in St. Louis, School of Social Work, St. Louis, MO, USA
| | - Victor Hong
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Joyce Song
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Sarah Ketchen Lipson
- Department of Health Law Policy and Management, School of Public Health, Boston University, Boston, MA, USA
| | - Daniel Eisenberg
- Department of Health Management and Policy, and Population Studies Center, University of Michigan, Ann Arbor, MI, USA
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Broglia E, Millings A, Barkham M. Challenges to addressing student mental health in embedded counselling services: a survey of UK higher and further education institutions. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2017. [DOI: 10.1080/03069885.2017.1370695] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Emma Broglia
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Abigail Millings
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Michael Barkham
- Department of Psychology, University of Sheffield, Sheffield, UK
- Centre for Psychological Services Research, Department of Psychology, University of Sheffield, Sheffield, UK
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16
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Chen RY, Feltes JR, Tzeng WS, Lu ZY, Pan M, Zhao N, Talkin R, Javaherian K, Glowinski A, Ross W. Phone-Based Interventions in Adolescent Psychiatry: A Perspective and Proof of Concept Pilot Study With a Focus on Depression and Autism. JMIR Res Protoc 2017; 6:e114. [PMID: 28623183 PMCID: PMC5493787 DOI: 10.2196/resprot.7245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 04/05/2017] [Accepted: 04/24/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed. OBJECTIVE The aim of this paper was to explore the utility of text message interventions in adolescent psychiatry and describe a user feedback-driven iterative design process for text message systems. METHODS We developed automated text message interventions using a platform for both depression (EpxDepression) and autism spectrum disorder (ASD; EpxAutism) and conducted 2 pilot studies for each intervention (N=3 and N=6, respectively). The interventions were prescribed by and accessible to the patients' healthcare providers. EpxDepression and EpxAutism utilized an automated system to triage patients into 1 of 3 risk categories based on their text responses and alerted providers directly via phone and an online interface when patients met provider-specified risk criteria. Rapid text-based feedback from participants and interviews with providers allowed for quick iterative cycles to improve interventions. RESULTS Patients using EpxDepression had high weekly response rates (100% over 2 to 4 months), but exhibited message fatigue with daily prompts with mean (SD) overall response rates of 66.3% (21.6%) and 64.7% (8.2%) for mood and sleep questionnaires, respectively. In contrast, parents using EpxAutism displayed both high weekly and overall response rates (100% and 85%, respectively, over 1 to 4 months) that did not decay significantly with time. Monthly participant feedback surveys for EpxDepression (7 surveys) and EpxAutism (18 surveys) preliminarily indicated that for both interventions, daily messages constituted the "perfect amount" of contact and that EpxAutism, but not EpxDepression, improved patient communication with providers. Notably, EpxDepression detected thoughts of self-harm in patients before their case managers or caregivers were aware of such ideation. CONCLUSIONS Text-message interventions in adolescent psychiatry can provide a cost-effective and engaging method to track symptoms, behavior, and ideation over time. Following the collection of pilot data and feedback from providers and patients, larger studies are already underway to validate the clinical utility of EpxDepression and EpxAutism. TRIAL REGISTRATION Clinicaltrials.gov NCT03002311; https://clinicaltrials.gov/ct2/show/NCT03002311 (Archived by WebCite at http://www.webcitation.org/6qQtlCIS0).
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Affiliation(s)
- Robert Yuzen Chen
- Washington University School of Medicine, St. Louis, MO, United States
| | | | | | - Zoe Yunzhu Lu
- Washington University School of Medicine, St. Louis, MO, United States
| | - Michael Pan
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Nan Zhao
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Rebecca Talkin
- Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Kavon Javaherian
- Washington University School of Medicine, St. Louis, MO, United States
| | - Anne Glowinski
- Washington University School of Medicine, Department of Psychiatry, Division of Child and Adolescent Psychiatry, St. Louis, MO, United States
| | - Will Ross
- Washington University School of Medicine, St. Louis, MO, United States
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