Abstract
BackgroundDepression is a very common condition that impairs functioning and is often untreated. More than 60% of the treatments for depressive disorder are administered in primary care settings by care providers who lack the time and expertise to treat depression. To address this issue, we developed Ascend, a therapist-supported, mobile phone–delivered 8-week intervention administered at the Meru Health Online Clinic in Finland.ObjectiveWe conducted two pilot studies to examine the feasibility of the Ascend intervention, specifically, dropout rates, daily practice, weekly group chat use, and changes in depression symptoms. We also explored whether daily practice and weekly group chat use were associated with changes in depression symptoms.MethodsA total of 117 Finnish adults with elevated depressive symptoms enrolled in Ascend, a program that included daily cognitive behavioral and mindfulness meditation exercises delivered through a mobile phone app, anonymous group chat with other users, and chat/phone access to a licensed therapist. Eight weekly themes were delivered in a fixed, sequential format. Depression symptoms were measured at baseline, every second week during the intervention, immediately after the intervention, and 4 weeks after completion of the intervention. Data were analyzed using intent-to-treat repeated-measures analysis of variance and linear regression models.ResultsFor studies 1 and 2, we observed dropout rates of 27% and 15%, respectively, decreasing daily practice and group chat use, and decreased depression symptoms from baseline to immediately and 4 weeks after the intervention (P<.001). We found that both more daily practice and chat group use predicted the occurrence of fewer depressive symptoms at 4 weeks postintervention (Study 1: ∆R2=.38, P=.004 and ∆R2=.38, P=.002, respectively; Study 2: ∆R2=.16, P<.001 and ∆R2=.08, P=.002, respectively).ConclusionsThis therapist-supported, mobile phone–delivered treatment for depression is feasible and associated with reduced depression symptoms. Design features that enhance daily practice and group chat use are areas of future investigation. Validation of these results using a controlled study design is needed to establish the evidence base for the Ascend intervention.
Highlights
BackgroundDepression is one of the most common mental disorders, impacting more than 300 million people worldwide according to the World Health Organization (WHO) [1]
Using linear regression analysis controlling for baseline levels of depression, we examined whether change in depression symptoms from baseline to 4 weeks postintervention was predicted by the number of days of practice during the intervention or the number of weeks of group chat use
Using a linear regression controlling for baseline depression symptoms, we found that greater number of days of practice significantly predicted a reduction in depressive symptoms from the baseline to 4 weeks postintervention (BDI-II; ∆ R2=.38; ∆ F1,20=11.14; P=.004; unstandardized coefficient beta=–0.45, standard error of beta=0.14, 95% CI=–0.74 to –0.17; Figure 3)
Summary
BackgroundDepression is one of the most common mental disorders, impacting more than 300 million people worldwide according to the World Health Organization (WHO) [1]. More than 60% of the treatments for depressive disorder are administered in primary care settings by care providers who lack the time and expertise to treat depression To address this issue, we developed Ascend, a therapist-supported, mobile phone–delivered 8-week intervention administered at the Meru Health Online Clinic in Finland. Objective: We conducted two pilot studies to examine the feasibility of the Ascend intervention, dropout rates, daily practice, weekly group chat use, and changes in depression symptoms. Results: For studies 1 and 2, we observed dropout rates of 27% and 15%, respectively, decreasing daily practice and group chat use, and decreased depression symptoms from baseline to immediately and 4 weeks after the intervention (P
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