Abstract
BackgroundDepression is projected to be the primary cause of disability worldwide by 2030. In a recent survey, the most commonly cited unmet need among 42.4% of depressed Albertans was the lack of sufficient, accessible, and affordable counselling. Our aim was to test the efficacy of a supportive text messaging mobile health intervention in improving treatment outcomes in depressed patients.MethodsWe performed a single-rater-blinded randomized trial involving 73 patients with Major Depressive Disorder. Patients in the intervention group (n = 35) received twice-daily supportive text messages for 3 months while those in the control group (n = 38) received a single text message every fortnight thanking them for participating in the study. The primary outcome of this study was: “Mean changes in the BDI scores from baseline“.ResultsAfter adjusting for baseline BDI scores, a significant difference remained in the 3 month mean BDI scores between the intervention and control groups: (20.8 (SD = 11.7) vs. 24.9 (SD = 11.5), F (1, 60) = 4.83, p = 0.03, ηp2 = 0.07). The mean difference in the BDI scores change was significant with an effect size (Cohen’s d) of 0.67. Furthermore, after adjusting for baseline scores, a significant difference remained in the 3 month mean self-rated VAS scores (EQ-5D-5 L scale) between the intervention and control groups, 65.7 (SD = 15.3) vs. 57.4 (SD = 22.9), F (1, 60) =4.16, p = 0.05, ηp2 = 0.065. The mean difference in change mean self-rated VAS scores was also statistically significant with an effect size (Cohen’s d) of 0.51.ConclusionsOur findings suggest that supportive text messages are a potentially useful psychological intervention for depression, especially in underserved populations. Further studies are needed to explore the implications of our findings in larger clinical samples.Trial registrationClinicalTrials.gov NCT02327858. Registered 24 December 2014.
Highlights
Depression is projected to be the primary cause of disability worldwide by 2030
After adjusting for these baseline Beck’s Depression Inventory II (BDI) scores, a significant difference remained in the 3 month BDI scores between the intervention and control groups (F (1, 60) = 4.83, p = 0.03, ηp2 = 0.07)
7% of the variance in the threemonth BDI was explained by the supportive text message intervention
Summary
Depression is projected to be the primary cause of disability worldwide by 2030. Our aim was to test the efficacy of a supportive text messaging mobile health intervention in improving treatment outcomes in depressed patients. Depression is projected to be the leading cause of disability worldwide by 2030 [1]. Mental illness is the most prevalent cause of disability in Canada, accountable for approximately 30% of all disability claims, 70% of total costs, and an economic loss of approximately 2.96% of GDP [1]. Slomp et al (2012) identified that approximately 5.9% of Albertans sought depression-related health services directly in 2007–2008 with a total annual service cost amounting to $114.5 million or approximately $550 per patient [4]. The distribution was heavily skewed with the 1% of the most costly patients accounting for an average annual cost of $25,862 per patient [1, 4]
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