Self-Help App for Depression in People With Intellectual Disabilities: A Randomized Clinical Trial

1. In this randomized clinical trial, the use of a smartphone self-help app was associated with increased self-esteem and quality of life, and a decrease in depressive symptoms in individuals with intellectual disabilities (IDs). 

Evidence Rating Level: 1 (Excellent) 

Intellectual disabilities (IDs) affect a small portion of the population, and around 34% of these individuals also experience mental health issues, especially depression, anxiety, and psychosis. These conditions are underdiagnosed due to diagnostic overshadowing and reliance on self-reporting. Although cognitive behavioural therapy is helpful, access to mental health care in this population is limited. One possible effective treatment alternative is smartphone-based interventions. This randomized clinical trial tested a self-help app called Happy, designed to reduce depression and boost self-esteem in people with IDs. This study aimed to assess the extent to which the app was accepted and whether it could improve mental well-being. 99 participants were randomized 1:1 to the intervention group (n=50) or the waiting list control group (n=49). Among the included participants, 93 completed the postintervention assessment. The intervention group had a significantly greater reduction in depressive symptoms compared to the control group (F1, 97 = 7.52, P = .007) with a medium effect size (np2=0.072). The intervention group also showed improvements in quality of life (QoL) (F1,97 = 5.09; ηp2 = 0.050 [small to medium effect]) (P = .03) and self-esteem (F1,97 = 17.94; ηp2 = 0.156 [large effect]) (P < .001). Overall, this randomized clinical trial found that this self-help was effective in reducing depressive symptoms and improving self-esteem and quality of life in individuals with IDs. 

Click here to read this study in JAMA Network Open

Image: PD

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