Anxiety, Depression… and Obesity?

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Considering how many people experience anxiety and/or depression, it is important that treatment be accessible (meaning, affordable) and safe (which is a difficult guarantee to find anywhere.) Enter: the smartphone. It has proved useful in other circumstances, and the prospect of smartphone-based treatments for these problems is a bright one.

In any given year, more than one quarter of the world’s people experience symptoms including “frequent nervousness, pervasive worry and pessimistic thoughts.” If untreated, they can progress into “full-threshold anxiety disorders.”

Last fall, a multi-authored report was published in the Journal of Affective Disorders, concerning smartphone-supported mental health interventions. The researchers, from Harvard Medical School, Swinburne University of Technology, and the Universities of Manchester, New South Wales, Melbourne, and Western Sydney, wanted to know more about smartphone-supported psychological interventions in relation to anxiety.

Up until recently, the treatment alternatives were anti-anxiety medications, including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and benzodiazepines; and psychological interventions, such as cognitive behavior therapy. Now, it appears that smartphone applications can perform in concert with one or both of those, and possibly even on their own.

The academians first defined a smartphone as any mobile device that can run applications. The report says:

We included all studies which aimed to improve mental health and/or psychological well-being using smartphones as a primary mode of delivery for the intervention, and compared this to a control condition, using random allocation of participants.

The researchers focused on nine randomized controlled trials (RCTs) involving 1,837 subjects. All met the criteria of “reporting changes in anxiety following mental health interventions delivered via smartphone devices,” and of being written in English. The authors concluded that psychological interventions delivered via smartphone devices could reduce anxiety, but then went on to say:

However, despite the rapid growth and great potential of this research area, there has been no systematic evaluation of the empirical evidence for using smartphones in the treatment of anxiety… [T]he role of mobile devices in the treatment and management of anxiety disorders has yet to be established.

Of course, as always in these studies of studies, intricate number-crunching is required. This avoids comparing apples to oranges, so to speak, and the paper explains in detail the statistical tools that were used to assure viability.

Depression

Another meta-study was published around the same time in World Psychiatry by pretty much the same group of researchers. This analysis of 18 RCTs encompassed 22 discrete interventions. The multitude of subjects, male and female, were between 18 and 59 years of age — 3,400 of them in all. Along with every degree of depression, their numbers included patients suffering from anxiety, bipolar disorder, and insomnia.

Depressive symptoms can be “significantly reduced” with a smartphone app, but so far that can confidently be said only of mild to moderate depression, but not the severe kind. As for methodology:

The researchers found no difference in apps which apply principles of mindfulness compared to cognitive behavioral therapy or mood monitoring programs. However, interventions that used entirely “self-contained” apps — meaning the app did not reply on other aspects such as clinician and computer feedback — were found to be significantly more effective than “non-self-contained” apps.

Your responses and feedback are welcome!

Source: “Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials,” ScienceDirect.com, 08/15/17
Source: “Smartphone apps can reduce depression,” ScienceDaily.com, 09/22/17
Photo credit: #L98 via Visualhunt/CC BY

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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