1. Erik Shwarts MD PhD1
, Steven R. Chan MD MBA1
, John Torous MD2
, Satish Misra MD3
, Peter Yellowlees MD MBBS1
Smartphone Apps for Anxiety
Mobile phones are increasingly being used amongst psychiatric
patients with a majority of psychiatric patients using devices that can
run applications9
. The increased commercial availability of
telepsychiatry and mobile counseling services has led to a variety of
ready-to-download apps on both Android and iOS devices. We
highlight apps available for patients with anxiety disorders to use as
an adjunct to psychiatric treatment, and review them accordingly.
A Review of Commercially Available Apps Using a Heuristic Review Framework
A variety of applications were found suitable for use for anxiety
disorders, but a number of applications that were available did not
meet full criteria for the heuristics framework. Not all applications
featured privacy policies. Some applications accessed features on the
device - such as the device's precise GPS-based location, access to
device's photos, and access to the phone's call log - not explained by
the app developer.
OBJECTIVE / BACKGROUND
METHOD
RESULTS
CONCLUSION
Smartphone apps can serve as a useful complement to existing
treatment. Interactive components in such apps make them useful
for self-help and serve as a more interactive form of bibliotherapy
and psychotherapy homework. However, numerous apps had
concerning security, privacy, and efficacy issues. Both clinicians
and patients should be wary of these prior to downloading,
purchasing, and using such apps.
A search was conducted on iOS's App Store — at https://www.
appannie.com/apps/all-stores/keyword-top/united-states/?
device=iphone&date=2015-04-12&word=anxiety — for anxiety apps
in the top 10 search criteria as ranked by the App Store. Although
the exact ranking algorithm is not published, the rankings are
generally thought to be determined by revenue and number of
downloads.
Apps were downloaded to a device that ran iOS. We then graded
apps on heuristic criteria that observed their efficacy, data security
and privacy, usability, features, and price. This heuristic
framework is based on recent academic and commercial literature
used to evaluate clinical informatics, telemedicine, and other
systems and adapted for mental health technologies, based on work
by Adam Powell and John Torous and colleagues10
.
4 =very easy; 0=very difficult
4 =highly likely; 0=highly unlikely
4 =complete ability; 0=no ability
4 =very interactive, helpful feedback
0 =not interactive, no feedback
3 =data from at least one
randomized controlled trial
2 =data from at least one non-
randomized non-controlled trial
1 =data from an open study
0 = no data provided
2 = research supported exclusively
by government agency or non-profit
organizations
1 = research supported in full or
part by for-profit organizations
0 = no data provided
3 =The application is designed to
improve a specific condition or
symptom
2 =The application is designed to
help with non-specific items such as
“mood” or “brain fitness”
1 =The application is designed to
track and monitor items such as
symptom severity or medication
0 = No data provided
2 =ratings exist from >50 users
1 =ratings exist from 25-50 users
0 =fewer than 25 user ratings
1 =yes; 0=no
A
B
C
D
E
F
G
H
J
1 2 3
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3. Pandey A, Hasan S, Dubey D, Sarangi S. Smartphone apps as a source of cancer information: changing trends in health information-seeking behavior. J Cancer Educ.
2013;28(1):138-42.
4. PsyberGuide Ratings – Explanation. PsyberGuide. http://psyberguide.org/psyberguide-ratings-explanation/ Accessed February 20, 2015.
5. Mobile Apps. Anxiety and Depression Association of America. http://www.adaa.org/finding-help/mobile-apps Accessed February 21, 2015.
6. Lewis TL. A systematic self-certification model for mobile medical apps. J Med Internet Res. 2013;15(4):e89.
7. Martínez-pérez B, De la torre-díez I, Candelas-plasencia S, López-coronado M. Development and evaluation of tools for measuring the quality of experience (QoE) in
mHealth applications. J Med Syst. 2013;37(5):9976.
8. Ferrero-Álvarez-Rementería J. et al. X. European Journal of ePractice. December 2013;(21): 14-26.
9. J. Torous, S.R. Chan, S. Tan, J. Behrens, I. Mathew, E. Conrad, L. Hinton, P. Yellowlees, M. Keshavan. “Smartphone Ownership and Interest in Mobile Applications to
Monitor Symptoms of Mental Health Conditions: A Survey Study of Four Geographically Distinct Clinics.” JMIR Mental Health 2014;1(1):e5 DOI: 10.2196/mental.4004
10. Powell A, Torous J, Chan SR, Shwarts E. “Evaluating mHealth App Evaluations.” In process, 2015.
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