scholarly journals Mobile Apps that Promote Emotion Regulation, Positive Mental Health and Wellbeing in the General Population: Systematic Review and Meta-analysis (Preprint)

10.2196/31170 ◽  
2021 ◽  
Author(s):  
Amelia Eisenstadt ◽  
Shaun Liverpool ◽  
Elisa Infanti ◽  
Roberta Maria Ciuvat ◽  
Courtney Carlsson
2021 ◽  
Author(s):  
Amelia Eisenstadt ◽  
Shaun Liverpool ◽  
Elisa Infanti ◽  
Roberta Maria Ciuvat ◽  
Courtney Carlsson

BACKGROUND Among the general public there appears to be a growing need and interest in receiving digital mental health and well-being support. In response to this, a number of mental health apps (MHapps) are becoming available for monitoring, managing and promoting positive mental health and well-being. Thus far, the evidence supports positive outcomes when users engage with digital interventions. However, there is high variability in the theoretical base informing MHapps and the features incorporated. Such differences can have implications for the efficacy of the apps and the level of engagement among specific target population groups. Moreover, such heterogeneity may influence the extent to which the data from various MHapps can be pooled to assess the strength of the evidence. OBJECTIVE We aimed to systematically review the available research on MHapps that promote emotion regulation, positive mental health, and well-being in the general population aged 18-45. More specifically, the review aimed at providing a systematic description of the theoretical background and features of MHapps while evaluating any potential effectiveness. METHODS A comprehensive literature search of key databases; MEDLINE (via Ovid), EMBASE (via Ovid), PsycINFO (via Ovid), Web of Science, and the Cochrane Register of Controlled Trials (CENTRAL) was conducted until January 2021. Studies were included if they described standalone mental health and well-being apps for adults without a formal mental health diagnosis. All studies were quality assessed against the Mixed Methods Appraisal Tool. In addition, the Cochrane risk-of-bias tool (ROB-2) was used to assess randomized control trials (RCTs). Data were extracted using a modified extraction form the Cochrane Handbook of Systematic Reviews. A narrative synthesis and meta-analysis was then undertaken to address the review aims. RESULTS In total, 3156 abstracts were identified. Of these, 52 publications describing 48 MHapps met the inclusion criteria. Together the studies evaluated interventions across 15 countries. Thirty-nine RCTs were identified that suggested there is some support for the role of individual MHapps in improving and promoting mental health and well-being. Regarding pooled effect, MHapps, when compared to controls, showed a small effect for reducing mental health symptoms (k = 19, g = -0.24, 95% CI [-0.34, -0.14], p < .05) and improving well-being (k = 13, g = 0.17, 95% CI [0.05, 0.29], p < .05), and a medium effect for emotion regulation (k = 6, g = 0.49, 95% CI [0.23,0.74], p<.05). There is also a wide knowledge base of creative and innovative ways to engage users in techniques, such as mood monitoring and guided exercises. Mindfulness and Cognitive Behavioural approaches appear to be the most common among MHapp developers. Studies were generally assessed to contribute unclear or high risk of bias, or be of medium to low methodological quality. CONCLUSIONS The emerging evidence for MHapps that promote positive mental health and well-being continue to show some evidence of promise. Despite a wide range of MHapps, there are not many that specifically promote emotion regulation. However, our findings may position emotion regulation as an important mechanism for inclusion in future positive mental health and well-being MHapps. A fair proportion of the included studies were pilot or feasibility trials (k = 17, 33%), and full scale RCTs reported high attrition rates and non-diverse samples. Given the number and pace at which MHapps are being released, further robust research is warranted to inform the development and testing of evidence-based programs. CLINICALTRIAL Mia Eisenstadt, Elisa Infanti, Shaun Liverpool. Characteristics and effectiveness of mobile apps that promote emotion regulation and well-being in the general population: a systematic review protocol. PROSPERO 2020 CRD42020213051 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020213051


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Angela M. Kunzler ◽  
Nikolaus Röthke ◽  
Lukas Günthner ◽  
Jutta Stoffers-Winterling ◽  
Oliver Tüscher ◽  
...  

Abstract Background Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. Methods For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. Results Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15–0.65) and depression (SMD 0.67; 95% CI 0.07–1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. Conclusions This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.


2020 ◽  
Vol 54 (10) ◽  
pp. 970-984 ◽  
Author(s):  
Nicholas Buckley ◽  
Emma J Glasson ◽  
Wai Chen ◽  
Amy Epstein ◽  
Helen Leonard ◽  
...  

Background: Children and adolescents with intellectual disability are at risk of developing psychiatric symptoms and disorders; yet, the estimates reported in the literature have been inconsistent, presenting a potential barrier for service planning and delivery. Sources of variability could arise from differences in measurement instruments as well as subgroup membership by severity of intellectual disability, gender and age. This systematic review aimed to address these gaps. Method: MEDLINE and PsycINFO databases were searched from inception to 2018 and selected studies were reviewed. Studies were included if they reported point prevalence estimates of mental health symptomology or diagnoses in a general population of 6- to 21-year-old individuals with intellectual disability. The Joanna Briggs Institute Prevalence Critical Appraisal Checklist was applied to eligible papers to appraise their scientific strength. Pooled prevalence for mental health symptomology was determined using a random-effects meta-analysis. Results: A total of 19 studies were included, including 6151 children and adolescents. The pooled prevalence estimate captured by the Developmental Behaviour Checklist was 38% (95% confidence interval = [31, 46]), contrasting with 49% (95% confidence interval = [46, 51]) captured by the Child Behaviour Checklist; both rates were higher than a non-intellectual disability population. Severity of intellectual disability did not significantly influence the Developmental Behaviour Checklist risks. Insufficient data were available to conduct statistical analyses on the effects of age, gender and socioeconomic status. Of diagnosed psychiatric disorders, attention deficit/hyperactivity disorder (30%), conduct disorder (3–21%) and anxiety disorders (7–34%) were the most prevalent conditions. Conclusion: This review consists of the largest sample hitherto evaluated. In the intellectual disability population, mental health comorbidities could be better detected by a symptom phenotype than a psychiatric diagnostic phenotype. Crucially, future research needs to address the effect of measurement validity in the intellectual disability population. Estimated prevalence rates were high compared to the general population, indicating the importance of systematic screening, case detection and appropriate management.


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