Purpose of Review
To summarize the latest evidence about mobile phone applications for the management of depression.
Depression apps are very heterogeneous, given the absence of standards for their development, description, and evaluation. Randomized clinical trials show the effectiveness of some of these applications in reducing depressive symptoms. Attrition is an important issue whose evaluation is limited by the frequent use of incentives in the studies.
The number of mobile applications for depression far exceeds the number of studies evaluating their efficacy and feasibility. Despite the limitations of the digital market, there are a small number of apps that have demonstrated sufficient effectiveness and tolerability to think of short-term clinical use. However, there are still barriers at different levels that may delay the implementation of these interventions in daily clinical practice.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Murray C, Lopez A. Measuring the global burden of disease. N Engl J Med. 2013;369(5):448–57. https://doi.org/10.1056/nejmra1201534.
Lawrence D, Hancock K, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population-based registers. BMJ. 2013;346(may21 1):f2539. https://doi.org/10.1136/bmj.f2539.
Rivera M, Porras-Segovia A, Rovira P, Molina E, Gutiérrez B, Cervilla J. Associations of major depressive disorder with chronic physical conditions, obesity and medication use: results from the PISMA-ep study.
Thornicroft G, Chatterji S, Evans-Lacko S, Gruber M, Sampson N, Aguilar-Gaxiola S, et al. Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry. 2017;210(02):119–24. https://doi.org/10.1192/bjp.bp.116.188078.
Peng W, Kanthawala S, Yuan S, Hussain SA. A qualitative study of user perceptions of mobile health apps. BMC Public Health. 2016;16(1):1158.
O’Dea B, Calear A, Perry Y. Is e-health the answer to gaps in adolescent mental health service provision? Curr Opin Psychiatry. 2015;28(4):336–42. https://doi.org/10.1097/yco.0000000000000170.
Poushter J. Smartphone ownership and internet usage continues to climb in emerging economies. Pew Res Cent. 2016;22.
Berrouiguet S, Perez-Rodriguez M, Larsen M, Baca-García E, Courtet P, Oquendo M. From eHealth to iHealth: transition to participatory and personalized medicine in mental health. J Med Internet Res. 2018;20(1):e2. https://doi.org/10.2196/jmir.7412.
• Proudfoot J, Clarke J, Birch M, et al. Impact of a mobile phone and web program on symptom and functional outcomes for people with mild-to-moderate depression, anxiety and stress: a randomised controlled trial. BMC Psychiatry. 2013;13(1). https://doi.org/10.1186/1471-244x-13-312. An RCT evaluating the app myCompass. There was a significant decrease in depressive symptoms. Most used features were short motivational messages and symptom tracking.
Torous J, Chan SR, Yee-Marie TS, Behrens J, Mathew I, Conrad EJ, et al. Patient smartphone ownership and interest in mobile apps to monitor symptoms of mental health conditions: a survey in four geographically distinct psychiatric clinics. JMIR Ment Health. 2014;1(1):e5. https://doi.org/10.2196/mental.4004.
Martínez-Pérez B, de la Torre-Díez I, López-Coronado M. Mobile health applications for the most prevalent conditions by the World Health Organization: review and analysis. J Med Internet Res. 2013;15(6):e120.
Tal A, Torous J. The digital mental health revolution: opportunities and risks. Psychiatr Rehab J. 2017;40(3):263–5. https://doi.org/10.1037/prj0000285.
•• Firth J, Torous J, Nicholas J, et al. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017;16(3):287–98. https://doi.org/10.1002/wps.20472. The first meta-analysis of RCTs evaluating apps for depression. Pooled results from 3414 participants showed a significant decrease in depressive symptoms.
Shen N, Levitan M-J, Johnson A, et al. Finding a depression app: a review and content analysis of the depression app marketplace. JMIR MHealth UHealth. 2015;3:e16.
Huguet A, Rao S, McGrath P, Wozney L, Wheaton M, Conrod J, et al. A systematic review of cognitive behavioral therapy and behavioral activation apps for depression. PLoS One. 2016;11(5):e0154248. https://doi.org/10.1371/journal.pone.0154248.
Kumar S, Nilsen W, Abernethy A, Atienza A, Patrick K, Pavel M. Mobile health technology evaluation. Am J Prev Med. 2013;45(2):228–36. https://doi.org/10.1016/j.amepre.2013.03.017.
Wisniewski H, Liu G, Henson P, Vaidyam A, Hajratalli NK, Onnela JP, et al. Understanding the quality, effectiveness and attributes of top-rated smartphone health apps. Evid Based Ment Health. 2019;22(1):4–9. https://doi.org/10.1136/ebmental-2018-300069.
Mathiasen K, Andersen TE, Riper H, Kleiboer AA, Roessler KK. Blended CBT versus face-to-face CBT: a randomised non-inferiority trial. BMC Psychiatry. 2016;16(1):432.
Rathbone AL, Clarry L, Prescott J. Assessing the efficacy of mobile health apps using the basic principles of cognitive behavioral therapy: systematic review. J Med Internet Res. 2017;19(11):e399. https://doi.org/10.2196/jmir.8598 Review.
Birney A, Gunn R, Russell J, Ary D. MoodHacker Mobile Web app with email for adults to self-manage mild-to-moderate depression: randomized controlled trial. JMIR Mhealth Uhealth. 2016;4(1):e8. https://doi.org/10.2196/mhealth.4231.
Emslie G, Kennard B, Mayes T, Nakonezny PA, Zhu L, Tao R, et al. Insomnia moderates outcome of serotonin-selective reuptake inhibitor treatment in depressed youth. J Child Adolesc Psychopharmacol. 2012;22(1):21–8. https://doi.org/10.1089/cap.2011.0096.
Horsch CH, Lancee J, Griffioen-Both F, Spruit S, Fitrianie S, Neerincx MA, et al. Mobile phone-delivered cognitive behavioral therapy for insomnia: a randomized waitlist controlled trial. J Med Internet Res. 2017;19(4):e70. https://doi.org/10.2196/jmir.6524.
Berrouiguet S, Baca-García E, Brandt S, Walter M, Courtet P. Fundamentals for future mobile-health (mHealth): a systematic review of mobile phone and Web-based text messaging in mental health. J Med Internet Res. 2016;18(6):e135. https://doi.org/10.2196/jmir.5066.
Nuij C, van Ballegooijen W, Ruwaard J, de Beurs D, Mokkenstorm J, van Duijn E, et al. Smartphone-based safety planning and self-monitoring for suicidal patients: rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study. Internet Interv. 2018;13:16–23. https://doi.org/10.1016/j.invent.2018.04.005 eCollection 2018 Sep.
Santo K, Richtering SS, Chalmers J, Thiagalingam A, Chow CK, Redfern J. Mobile phone apps to improve medication adherence: a systematic stepwise process to identify high-quality apps. JMIR Mhealth Uhealth. 2016;4(4):e132.
Bennabi D, Aouizerate B, El-Hage W, Doumy O, Moliere F, Courtet P, et al. Risk factors for treatment resistance in unipolar depression: a systematic review. J Affect Disord. 2015;171:137–41. https://doi.org/10.1016/j.jad.2014.09.020.
• Mo Y, Gong W, Wang J, Sheng X, Xu D. The association between the use of antenatal care smartphone apps in pregnant women and antenatal depression: cross-sectional study. JMIR Mhealth Uhealth. 2018;6(11):e11508. https://doi.org/10.2196/11508. A cross-sectional study performed in 1304 pregnant women. The explored antenatal care apps had a significant protective effect on antenatal depression.
Fleming J, Hill Y, Burns M. Usability of a culturally informed mHealth intervention for symptoms of anxiety and depression: feedback from young sexual minority men. JMIR Hum Factors. 2017;4(3):e22. https://doi.org/10.2196/humanfactors.7392.
Hetrick SE, Robinson J, Burge E, Blandon R, Mobilio B, Rice SM, et al. Youth codesign of a mobile phone app to facilitate self-monitoring and management of mood symptoms in young people with major depression, suicidal ideation, and self-harm. JMIR Ment Health. 2018;5(1):e9. https://doi.org/10.2196/mental.9041.
Grist R, Porter J, Stallard P. Mental health mobile apps for preadolescents and adolescents: a systematic review. J Med Internet Res. 2017;19(5):e176. https://doi.org/10.2196/jmir.7332.
• Hur J, Kim B, Park D, Choi S. A scenario-based cognitive behavioral therapy mobile app to reduce dysfunctional beliefs in individuals with depression: a randomized controlled trial. Telemed e-Health. 2018;24(9):710–6. https://doi.org/10.1089/tmj.2017.0214. One of the most recent RCT on apps for depression; it evaluated the app Todac-Todac, showing a significant decrease in depressive symptoms and negative beliefs.
• Pratap A, Renn B, Volponi J, et al. Using mobile apps to assess and treat depression in Hispanic and Latino populations: fully remote randomized clinical trial. J Med Internet Res. 2018;20(8):e10130. https://doi.org/10.2196/10130. An RCT that tested the mobile applications iPST, Project EVO, and Health Tips. There was a significant decrease in depressive symptoms.
Arean P, Hallgren K, Jordan J, Gazzaley A, Atkins DC, Heagerty PJ, et al. The use and effectiveness of mobile apps for depression: results from a fully remote clinical trial. J Med Internet Res. 2016;18(12):e330. https://doi.org/10.2196/jmir.6482.
Baumel A, Tinkelman A, Mathur N, Kane J. Digital peer-support platform (7Cups) as an adjunct treatment for women with postpartum depression: feasibility, acceptability, and preliminary efficacy study. JMIR Mhealth Uhealth. 2018;6(2):e38. https://doi.org/10.2196/mhealth.9482.
Corden M, Koucky E, Brenner C, et al. MedLink: a mobile intervention to improve medication adherence and processes of care for treatment of depression in general medicine. Digit Health. 2016;2:205520761666306. https://doi.org/10.1177/2055207616663069.
Fogarty AS, Proudfoot J, Whittle EL, Clarke J, Player MJ, Christensen H, et al. Preliminary evaluation of a brief Web and mobile phone intervention for men with depression: men’s positive coping strategies and associated depression, resilience, and work and social functioning. JMIR Ment Health. 2017;4(3):e33. https://doi.org/10.2196/mental.7769.
Furukawa T, Horikoshi M, Fujita H, Tsujino N, Jinnin R, Kako Y, et al. Cognitive and behavioral skills exercises completed by patients with major depression during smartphone cognitive behavioral therapy: secondary analysis of a randomized controlled trial. JMIR Ment Health. 2018;5(1):e4. https://doi.org/10.2196/mental.9092.
Goldin P, Lindholm R, Ranta K, Hilgert O, Helteenvuori T, Raevuori A. Feasibility of a therapist-supported, mobile phone–delivered online intervention for depression: longitudinal observational study. JMIR Form Res. 2019;3(1):e11509. https://doi.org/10.2196/11509.
Mantani A, Kato T, Furukawa T, Horikoshi M, Imai H, Hiroe T, et al. Smartphone cognitive behavioral therapy as an adjunct to pharmacotherapy for refractory depression: randomized controlled trial. J Med Internet Res. 2017;19(11):e373. https://doi.org/10.2196/jmir.8602.
Mohr D, Montague E, Stiles-Shields C, et al. MedLink: a mobile intervention to address failure points in the treatment of depression in general medicine, Proceedings of the 9th International Conference on Pervasive Computing Technologies for Healthcare. 2015. https://doi.org/10.4108/icst.pervasivehealth.2015.259042.
Mohr D, Tomasino K, Lattie E, Palac HL, Kwasny MJ, Weingardt K, et al. IntelliCare: an eclectic, skills-based app suite for the treatment of depression and anxiety. J Med Internet Res. 2017;19(1):e10. https://doi.org/10.2196/jmir.6645.
O'Toole M, Arendt M, Pedersen C. Testing an app-assisted treatment for suicide prevention in a randomized controlled trial: effects on suicide risk and depression. Behav Ther. 2019;50(2):421–9. https://doi.org/10.1016/j.beth.2018.07.007.
Schlosser D, Campellone T, Truong B, et al. Efficacy of PRIME, a mobile app intervention designed to improve motivation in young people with schizophrenia. Schizophr Bull. 2018;44(5):1010–20. https://doi.org/10.1093/schbul/sby078.
Silva-Almodovar A, Surve S, Axon D, Cooper D, Nahata M. Self-directed engagement with a mobile app (Sinasprite) and its effects on confidence in coping skills, depression, and anxiety: retrospective longitudinal study. JMIR Mhealth Uhealth. 2018;6(3):e64. https://doi.org/10.2196/mhealth.9612.
Whitton A, Proudfoot J, Clarke J, Birch MR, Parker G, Manicavasagar V, et al. Breaking open the black box: isolating the most potent features of a Web and mobile phone-based intervention for depression, anxiety, and stress. JMIR Ment Health. 2015;2(1):e3. https://doi.org/10.2196/mental.3573.
Eysenbach G. The law of attrition. J Med Internet Res. 2005;7(1):e11. https://doi.org/10.2196/jmir.7.1.e11.
Fuller-Tyszkiewicz M, Richardson B, Klein B, Skouteris H, Christensen H, Austin D, et al. A mobile app–based intervention for depression: end-user and expert usability testing study. JMIR Ment Health. 2018;5(3):e54. https://doi.org/10.2196/mental.9445.
Lipschitz J, Miller CJ, Hogan TP, Burdick KE, Lippin-Foster R, Simon SR, et al. Adoption of mobile apps for depression and anxiety: cross-sectional survey study on patient interest and barriers to engagement. JMIR Ment Health. 2019;6(1):e11334. https://doi.org/10.2196/11334.
BinDhim N, Shaman A, Trevena L, Basyouni M, Pont L, Alhawassi T. Depression screening via a smartphone app: cross-country user characteristics and feasibility. J Am Med Inform Assoc. 2014. https://doi.org/10.1136/amiajnl-2014-002840.
Stiles-Shields C, Montague E, Lattie E, Kwasny M, Mohr D. What might get in the way: barriers to the use of apps for depression. Digit Health. 2017;3:205520761771382. https://doi.org/10.1177/2055207617713827.
Erbes CR, Stinson R, Kuhn E, Polusny M, Urban J, Hoffman J, et al. Access, utilization, and interest in mHealth applications among veterans receiving outpatient care for PTSD. Mil Med. 2014;179(11):1218–22. https://doi.org/10.7205/MILMED-D-14-00014.
Bower DJ, Barry N, Reid M, Norrie J. Designing and implementing e-health applications in the UK’s National Health Service. J Health Commun. 2005;10(8):733–50.
Schueller SM, Neary M, O'Loughlin K, Adkins EC. Discovery of and interest in health apps among those with mental health needs: survey and focus group study. J Med Internet Res. 2018;20(6):e10141. https://doi.org/10.2196/10141.
Miller CJ, McInnes DK, Stolzmann K, Bauer MS. Interest in use of technology for healthcare among veterans receiving treatment for mental health. Telemed J E Health. 2016;22(10):847–54.
Kaipainen K, Välkkynen P, Kilkku N. Applicability of acceptance and commitment therapy-based mobile app in depression nursing. Transl Behav Med. 2017;7(2):242–53. https://doi.org/10.1007/s13142-016-0451-3.
Griebel L, Enwald H, Gilstad H, Pohl AL, Moreland J, Sedlmayr M. eHealth literacy research-quo vadis? Inform Health Soc Care. 2018;43(4):427–42. https://doi.org/10.1080/17538157.2017.1364247.
Anderson K, Burford O, Emmerton L. Mobile health apps to facilitate self-care: a qualitative study of user experiences. PLoS One. 2016;11(5):e0156164. https://doi.org/10.1371/journal.pone.0156164 eCollection 2016.
Yasini M, Beranger J, Desmarais P, Perez L, Marchand G. mHealth quality: a process to seal the qualified mobile health apps. Stud Health Technol Inform. 2016;228:205–9.
Lee TT, Kesselheim AS. U.S. Food and Drug Administration precertification pilot program for digital health software: weighing the benefits and risks. Ann Intern Med. 2018;168(10):730–2. https://doi.org/10.7326/M17-2715.
Chan S, Torous J, Hinton L, Yellowlees P. Towards a framework for evaluating mobile mental health apps. Telemed J E Health. 2015;21(12):1038–41. https://doi.org/10.1089/tmj.2015.0002.
The editors would like to thank Dr. Pilar A. Sáiz for taking the time to review this manuscript.
Conflict of Interest
Alejandro Porras-Segovia, Isaac Díaz-Oliván, Luis Gutiérrez-Rojas, Henry Dunne, Manon Moreno, and Enrique Baca-García each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Mood Disorders
About this article
Cite this article
Porras-Segovia, A., Díaz-Oliván, I., Gutiérrez-Rojas, L. et al. Apps for Depression: Are They Ready to Work?. Curr Psychiatry Rep 22, 11 (2020). https://doi.org/10.1007/s11920-020-1134-9