Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 20:8:e53204.
doi: 10.2196/53204.

Prospective Acceptability of Digital Therapy for Major Depressive Disorder in France: Multicentric Real-Life Study

Odile Amiot #  1 , Anne Sauvaget #  2 , Isabelle Alamome  3 , Samuel Bulteau  4   5 , Thomas Charpeaud  6 , Anne-Hélène Clair  7 , Philippe Courtet  8   9 , Dominique Drapier  10   11 , Emmanuel Haffen  12 , Eric Fakra  13 , Christian Gaudeau-Bosma  14 , Adeline Gaillard  15 , Stéphane Mouchabac  16 , Fanny Pineau  17 , Véronique Narboni  18 , Anne Duburcq  19 , Laurent Lecardeur  20
Affiliations

Prospective Acceptability of Digital Therapy for Major Depressive Disorder in France: Multicentric Real-Life Study

Odile Amiot et al. JMIR Form Res. .

Abstract

Background: Major depressive disorder is one of the leading causes of disability worldwide. Although most international guidelines recommend psychological and psychosocial interventions as first-line treatment for mild to moderate depression, access remains limited in France due to the limited availability of trained clinicians, high costs for patients in the context of nonreimbursement, and the fear of stigmatization. Therefore, online blended psychological treatment such as Deprexis could improve access to care for people with depression. It has several advantages, such as easy accessibility and scalability, and it is supported by evidence.

Objective: This study aims to evaluate the real-life acceptability of Deprexis for people with depression in France outside of a reimbursement pathway.

Methods: Deprexis Acceptability Study Measure in Real Life (DARE) was designed as a multicenter cross-sectional study in which Deprexis was offered to any patient meeting the inclusion criteria during the fixed inclusion period (June 2022-March 2023). Inclusion criteria were (1) depression, (2) age between 18 and 65 years, (3) sufficient French language skills, and (4) access to the internet with a device to connect to the Deprexis platform. Exclusion criteria were previous or current diagnoses of bipolar disorder, psychotic symptoms, and suicidal thoughts during the current episode. The primary objective was to measure the prospective acceptability of Deprexis, a new digital therapy. Secondary objectives were to examine differences in acceptability according to patient and clinician characteristics and to identify reasons for refusal. All investigators received video-based training on Deprexis before enrollment to ensure that they all had the same level of information and understanding of the program.

Results: A total of 245 patients were eligible (n=159, 64.9% were women and n=138, 56.3% were single). The mean age was 40.7 (SD 14.1) years. A total of 78% (n=191) of the patients had moderate to severe depression (according to the Patient Health Questionnaire-9 [PHQ-9]). More than half of the population had another psychiatric comorbidity (excluding bipolar disorder, psychotic disorders, and suicidal ideation). A total of 33.9% (n=83) of patients accepted the idea of using Deprexis; the main reason for refusal was financial at 83.3% (n=135). Multivariate logistic regression identified factors that might favor the acceptability of Deprexis. Among these, being a couple, being treated with an antidepressant, or having a low severity level favored the acceptance of Deprexis.

Conclusions: DARE is the first French study aiming at evaluating the prospective acceptability of digital therapy in the treatment of depression. The main reason for the refusal of Deprexis was financial. DARE will allow better identification of factors influencing acceptability in a natural setting. This study highlights the importance of investigating factors that may be associated with the acceptability of digital interventions, such as marital status, medication use, and severity of depression.

Keywords: depression; deprexis; digital health; e-mental health; prospective acceptability; psychotherapy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors received financial support from Ethypharm Digital Therapy (EDT) for patient recruitment in this study. OA, AS, AHC, PC, DD, EH, EF, and LL received financial compensation from EDT for their participation in the advisory board. EH has served in an advisory capacity; has conducted clinical trials related to the development of a drug; has received personal research, study, or travel funding; has made presentations at meetings; and has received remuneration for his contributions from the following pharmaceutical organizations: Janssen, Lundbeck, Otsuka, EISAI, CEMKA, Ethypharm, Neuraxpharm, and Sanofi. EH held a senior position in the FondaMental Foundation (Créteil) and the French Association of Biological Psychiatry and Neuropsychopharmacology (Paris). IA received personal travel expenses and gave presentations at meetings for Janssen, Otsuka, and Lundbeck. AHC has received honoraria from Ethypharm Digital Therapy outside the submitted work, and along with PC and EH received financial support for being speakers at symposia. AD is a consultant for CEMKA. LL is a consultant to DueL. VN was employed by EDT. EF is a consultant for Ethypharm, Janssen, and Lundbeck. AGG received financial support for travel expenses for a conference. SM received fees related to the subject matter of the article from the following companies: Ethypharm, Dallia, Did2are.

Figures

Figure 1
Figure 1
Proposed terminology for technology acceptance lifecycle according to Nadal et al [16].
Figure 2
Figure 2
Results of the multivariate logistic regression explaining acceptation of Deprexis. OR: odds ratio; PHQ-9: Patient Health Questionnaire-9.
See this image and copyright information in PMC

References

    1. Arias-de la Torre J, Vilagut G, Ronaldson A, Serrano-Blanco A, Martín V, Peters M, Valderas JM, Dregan A, Alonso J. Prevalence and variability of current depressive disorder in 27 European countries: a population-based study. Lancet Public Health. 2021;6(10):e729–e738. doi: 10.1016/S2468-2667(21)00047-5. https://linkinghub.elsevier.com/retrieve/pii/S2468-2667(21)00047-5 S2468-2667(21)00047-5 - DOI - PMC - PubMed
    1. The impact of COVID-19 on mental health cannot be made light of. World Health Organization. [2024-04-16]. https://www.who.int/news-room/feature-stories/detail/the-impact-of-covid... .
    1. Cuijpers P, Schoevers RA. Increased mortality in depressive disorders: a review. Curr Psychiatry Rep. 2004;6(6):430–437. doi: 10.1007/s11920-004-0007-y. - DOI - PubMed
    1. Rapport sur la qualification d’une approche population centrée et partenariale en santé mentale. France Stratégie, République Française. [2024-04-16]. https://www.strategie.gouv.fr/publications/rapport-qualification-dune-ap... .
    1. Andersson G, Titov N, Dear BF, Rozental A, Carlbring P. Internet-delivered psychological treatments: from innovation to implementation. World Psychiatry. 2019;18(1):20–28. doi: 10.1002/wps.20610. https://europepmc.org/abstract/MED/30600624 - DOI - PMC - PubMed

LinkOut - more resources