Description
Depression is the third largest contributor to global disease and is the most costly mental disorder in Europe. Cognitive-behavioral therapy (CBT) is the psychological standard in the treatment of depression; it can be delivered in classical format (face-to-face), or via the Internet. Automated CBT has emerged as a solution that can be as effective as the classical CBT, however it has high dropout rates (50%-60%) and limited long-term benefits. Given these shortcomings, we will use insights from Graphic Design, “serious games” and AI to develop an automated application aimed at both prevention and intervention for depression. This application will provide better outcomes than existing solutions. Leveraging the partnership developed with Checkware and the Norwegian University of Science and Technology, we will build a multinational team of experts who will help build the application, but also consolidate the relationships between partner states. As a result of this project, a new treatment option will be available to the public, based on cutting-edge research and development in psychology and computer sciences. The treatment option will raise the bar of what is possible in the field of automated interventions for depression.
Summary of project results
The general object matter of this project was the development and preliminary testing of the clinical utility of an integrated computerized platform to serve depression prevention and treatment and to go beyond the limits of the existent apps built up on the principles of cognitive-behavioral therapy (CBT). Our approach is thought to provide the conditions for going beyond the limits of the existent solutions due to cognitive-behavioral computerized psychotherapeutic intervention/assistance in depression (for instance, the extremely high rate of prematurely rejecting treatment, the limited efficiency of these interventions in the long run, the reduced degree of treatment customization etc.). We have designed a new app for smartphones, currently available in Romanian, English and Norwegian, both in PlayStore, as well as in AppStore. The app is being supported by a therapists’ platform, which allows the development of research activites, as well as clinical monitoring activities. To reach this, a first step was accomplishing a literature synthesis (published in 2016 within an international journal) on the online CBT interventions for depression, in terms of positive aspects and aspects to be improved. The subsequent activities involved a tight collaboration between programmers and clinicians, afterwards reflected into the users’ adhesion to the app delivered therapeutic programme and into the quality of user experience. Throughout 2015 – 2017, two controlled clinical trials were run to test the effectiveness of this app in preventing and reducing depressive symptoms. Both research protocols were published, and two manuscripts on the results gained are pending publication. By performing these trials, about 400 people benefited from free assistance in what concerns psycho-education for mental health, but also the treatment of depressive symptoms, and over 1500 people benefited from free psychological screening. An indirect result of the project is increasing the awareness on depression, its implications, but also its prevention and treatment, at the level of general population, especially the young aged. We have set to further promote the app among clinicians, in order to be used within the therapeutic protocols. Similarly, by developing the English and Norwegian versions of the app, we set to extend the research on the population at risk, but not only, both in the USA, through the contacts of the project manager, dr. Cezar Giosan, as well as in Norway through the partners from NTNU and CheckWare AS.
Summary of bilateral results
Results made in the project by partnership Partner 1 - CheckWare AS had an essential contribution in what concerns collecting the data in a correct, automatic and secure manner. During the project, the programmers team of the PP constantly collaborated with the team P1 in order to integrate the two data collecting platforms - Checkware platform and Dcombat platform. Team P1 provided team PP with an intensive training of using its platform, during a working trip in Norway, along with a platform user guide. Moreover, team P1 was involved in testing the app in the stage of establishing its feasibility and acceptability. At present, there are intentions to continue the collaboration by developing new research projects, but also app monetarization ones. Partner 2 - NTNU was constantly involved in developing the clinical contents of the app - courses, exercises, video segments etc, in testing it in the stage of establishing feasibility and acceptability, in conceiving the protocols of the controlled clinical trials and in the results analysis stage. An essential contribution of P2 was translating the app into Norwegian and piloting its version, which opens new collaboration opportunities in research projects concerning the online apps for promoting mental health.