One-year outcomes of a therapist-supported, smartphone-based intervention for elevated symptoms of depression and anxiety

Depression is common and severely impacts physical, psychological and social functioning. To address access barriers to care, we developed Ascend - a smartphone-delivered, therapist-supported, 8-week intervention based on several evidence-based psychological treatments for depression and anxiety. We examined whether the previously-reported, end-of-treatment improvements among 102 adults with elevated symptoms of depression extended up to 12 months post-treatment for depression symptoms (measured by the Patient Health Questionnaire [PHQ-9]), and up to 6 months post-treatment for anxiety symptoms (added to the intervention later, and measured by the Generalized Anxiety Disorder scale [GAD-7]). An intention-to-treat analysis showed that participants maintained clinically significant improvements in depression (mean PHQ-9 reduction=6.67, Hedges’ g = 1.14 [0.78 to 1.49]) and in anxiety (mean GAD-7 reduction=4.26, Hedges’ g = 0.91 [0.54 to 1.28]) at follow-up. Also, 60% of participants above the cutoff for major depression at baseline (PHQ ≥ 10) experienced ≥ 50% reduction in PHQ-9 score and had PHQ-9 < 10 at follow-up. Future randomized trials are warranted to test Ascend as a scalable solution to the treatment of depression and/or symptoms of anxiety.