J Am Med Inform Assoc - Depression screening via a smartphone app: cross-country user characteristics and feasibility.


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CKGROUND AND OBJECTIVE: Smartphone applications (apps) have the potential to be valuable self-help interventions for depression screening. However, information about their feasibility and effectiveness and the characteristics of app users is limited. The aim of this study is to explore the uptake, utilization, and characteristics of voluntary users of an app for depression screening.METHODS: This was a cross-sectional study of a free depression screening smartphone app that contains the demographics, patient health questionnaire (PHQ-9), brief anxiety test, personalized recommendation based on the participant's results, and links to depression-relevant websites. The free app was released globally via Apple's App Store. Participants aged 18 and older downloaded the study app and were recruited passively between September 2012 and January 2013.FINDINGS: 8241 participants from 66 countries had downloaded the app, with a response rate of 73.9%. While one quarter of the participants had a previous diagnosis of depression, the prevalence of participants with a higher risk of depression was 82.5% and 66.8% at PHQ-9 cut-off 11 and cut-off 15, respectively. Many of the participants had one or more physical comorbid conditions and suicidal ideation. The cut-off 11 (OR: 1.4; 95% CI 1.2 to 1.6), previous depression diagnosis (OR: 1.3; 95% CI1.2 to 1.5), and postgraduate educational level (OR: 1.2; 95% CI 1.0 to 1.5) were associated with completing the PHQ-9 questionnaire more than once.CONCLUSIONS: Smartphone apps can be used to deliver a screening tool for depression across a large number of countries. Apps have the potential to play a significant role in disease screening, self-management, monitoring, and health education, particularly among younger adults.

Resumo Limpo

ckground object smartphon applic app potenti valuabl selfhelp intervent depress screen howev inform feasibl effect characterist app user limit aim studi explor uptak util characterist voluntari user app depress screeningmethod crosssect studi free depress screen smartphon app contain demograph patient health questionnair phq brief anxieti test person recommend base particip result link depressionrelev websit free app releas global via appl app store particip age older download studi app recruit passiv septemb januari find particip countri download app respons rate one quarter particip previous diagnosi depress preval particip higher risk depress phq cutoff cutoff respect mani particip one physic comorbid condit suicid ideat cutoff ci previous depress diagnosi ci postgradu educ level ci associ complet phq questionnair onceconclus smartphon app can use deliv screen tool depress across larg number countri app potenti play signific role diseas screen selfmanag monitor health educ particular among younger adult

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