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Meta-Analysis
. 2017 Aug 15:218:15-22.
doi: 10.1016/j.jad.2017.04.046. Epub 2017 Apr 25.

Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials

Joseph Firth  1 , John Torous  2 , Jennifer Nicholas  3 , Rebekah Carney  4 , Simon Rosenbaum  3 , Jerome Sarris  5
Affiliations
Free article
Meta-Analysis

Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials

Joseph Firth et al. J Affect Disord. .
Free article

Abstract

Background: Various psychological interventions are effective for reducing symptoms of anxiety when used alone, or as an adjunct to anti-anxiety medications. Recent studies have further indicated that smartphone-supported psychological interventions may also reduce anxiety, although the role of mobile devices in the treatment and management of anxiety disorders has yet to be established.

Methods: We conducted a systematic review and meta-analysis of all randomized clinical trials (RCTs) reporting the effects of psychological interventions delivered via smartphone on symptoms of anxiety (sub-clinical or diagnosed anxiety disorders). A systematic search of major electronic databases conducted in November 2016 identified 9 eligible RCTs, with 1837 participants. Random-effects meta-analyses were used to calculate the standardized mean difference (as Hedges' g) between smartphone interventions and control conditions.

Results: Significantly greater reductions in total anxiety scores were observed from smartphone interventions than control conditions (g=0.325, 95% C.I.=0.17-0.48, p<0.01), with no evidence of publication bias. Effect sizes from smartphone interventions were significantly greater when compared to waitlist/inactive controls (g=0.45, 95% C.I.=0.30-0.61, p<0.01) than active control conditions (g=0.19, 95% C.I.=0.07-0.31, p=0.003).

Limitations: The extent to which smartphone interventions can match (or exceed) the efficacy of recognised treatments for anxiety has yet to established.

Conclusions: This meta-analysis shows that psychological interventions delivered via smartphone devices can reduce anxiety. Future research should aim to develop pragmatic methods for implementing smartphone-based support for people with anxiety, while also comparing the efficacy of these interventions to standard face-to-face psychological care.

Keywords: Anxiety disorders; Apps; Obsessive-compulsive disorder; Panic disorder; e-health; mhealth.

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