When Depression Lingers- Is There an App for That?

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In past blogs, I have written about the value of digital mental health in helping alleviate the burden of depression and anxiety via mindfulness meditation and cognitive behavioral therapy. What happens when symptoms linger, and people don’t get back to functioning optimally? Maybe they still struggle with low mood, low energy, or even have trouble sleeping. Can a digital solution add value to those suffering from residual symptoms?

A new paper by Zindel Segal and colleagues from the University of Toronto published in JAMA Psychiatry examines the role of mindfulness-based cognitive therapy (MMB) in addressing residual symptoms.

Lingering effects of an episode of depression are not well address in current models of care, and often these patients are left to manage outside of healthcare. Digital tools offer new ways to track and support ongoing skill-building, in essence, a way to close a current gap in care. The authors randomized participants from patients seen in primary and specialty care in an integrated delivery healthcare system, 480 people were randomly assigned to usual care or usual place plus access to MMB. The intervention consisted of 8 sessions delivered online over a three month period with access to a phone or email-based support. Outcomes tracked included the depression screener (PHQ9), rates of relapse, and remission. Secondary outcomes included the number of depression-free days and anxiety. Results were monitored over 15 months at three and 12 months post-intervention. Data completion rates were 78.7% at three months and 71.7% at twelve months respectively.

Findings indicate those in the intervention group had a more significant reduction in depressive symptoms compared to usual care. They also had higher rates of remission and lower rates of relapse. They also experienced more depression-free days. Improvement in mental functioning was also reported in the intervention group, but no difference was seen in physical functioning.

These findings are very encouraging as they point to a scalable solution that can reliably reduce the burden of suffering in a population that has not been well served by traditional care models. Depression is a challenging illness of the sufferer and those who support them through their lives. Finding ways to get people back into their full lives is imperative as health care gets more complex, and digital tools offer one way to combat the fragmentation we currently have.


Thanks for reading – Trina
(Opinions are my own)



Segal ZV, Dimidjian S, Beck A, et al. Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients With Residual Depressive Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. Published online January 29, 2020. doi:10.1001/jamapsychiatry.2019.4693


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