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. 2023 Oct 24;66(1):e82.
doi: 10.1192/j.eurpsy.2023.2453.

Understanding the potential of digital therapies in implementing the standard of care for depression in Europe

Philippe Courtet  1 , Odile Amiot  2 , Enrique Baca-Garcia  3   4   5   6   7   8   9 , Lara Bellardita  10 , Giancarlo Cerveri  11 , Anne-Hélène Clair  12 , Diego De Leo  13 , Dominique Drapier  14 , Eric Fakra  15   16 , Francis Gheysen  17 , Lucas Giner  18 , Ana Gonzalez-Pinto  19 , Gualberto Gussoni  20 , Emmanuel Haffen  21 , Laurent Lecardeur  22 , Fermin Mayoral-Cleries  23 , Francesco Saverio Mennini  24   25 , Pilar A Sáiz  8   26   27 , Eduard Vieta  28 , Diego Alberto Hidalgo  29 , Umberto Volpe  30
Affiliations

Understanding the potential of digital therapies in implementing the standard of care for depression in Europe

Philippe Courtet et al. Eur Psychiatry. .

Abstract

Depressive disorders represent the largest proportion of mental illnesses, and by 2030, they are expected to be the first cause of disability-adjusted life years [1]. The COVID-19 pandemic exacerbated prevalence and burden of depression and increased the occurrence of depressive symptoms in general population [2]. The urgency of implementing mental health services to address new barriers to care persuaded clinicians to use telemedicine to follow patients and stay in touch with them, and to explore digital therapeutics (DTx) as potential tools for clinical intervention [2]. The combination of antidepressants and psychotherapy is widely recommended for depression by international guidelines [3] but is less frequently applied in real-world practice. Commonly used treatments are pharmacological, but while being effective, some aspects such as adherence to the drug regimen, residual symptoms, resistance, lack of information, and stigma may hinder successful treatment. In case of less severe depression, standalone psychological therapies should be the first-line treatment option [3], but access to trained psychotherapists remains inequitable. DTx are evidence-based therapies driven by software programs to treat or complement treatment of a specific disease. DTx are classified as Medical Devices, and given their therapeutic purpose, they need to be validated through randomized controlled clinical trials, as for drug-based therapies. In the last 10 years, studies of digital interventions have proliferated; these studies demonstrate that digital interventions increase remission rates and lower the severity of depressive symptoms compared with waitlist, treatment as usual, and attention control conditions [4]. Despite the efficacy demonstrated in clinical trials, many of these tools never reach real-life patients; thus, it might be necessary to implement DTx in the public health system to expand access to valid treatment options. In this framework, DTx represent a good opportunity to help people with depression receive optimal psychotherapeutic care [5].

Keywords: DTx; Deprexis; Digital therapeutics; depression.

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Conflict of interest statement

E.V. has received grants and served as consultant, advisor, or CME speaker for the following entities (unrelated to the present work): AB-Biotics, Abbott, Abbvie, Aimentia, Angelini, Biogen, Biohaven, Boehringer-Ingelheim, Casen-Recordati, Celon, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo Smith-Kline, Janssen, Lundbeck, Organon, Otsuka, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris. P.A.S. has been a consultant to and/or has received honoraria or grants from Adamed, Angelini, CIBERSAM, Ethypharm Digital Therapy, European Commission, Government of the Principality of Asturias, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Plan Nacional Sobre Drogas, and Servier. The other authors declare no potential competing interest.

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