Anti-Depression App is a resource for depression management which consists of three components. The “Assess” component provides the user with a diagnostic for evaluating potential symptoms of depression. When users indicate a symptom, they are both referred to an article in the “Resources” section of the app and instructed to complete an activity, such as tracking food intake in the “Progress Tracker” section. After completing the assessment, the user is given a list of recommended actions to take over the course of the following week. One action (e.g. make self-care a priority, concentrate on your relationships) is recommended for each day.
While the “Assess” component drives users towards the other components of the app, they may also refer to them directly. The “Resources” section contains audio recordings of the questions in the assessment for people who cannot read, a series of seven book chapters from an eBook written for the app, and a list of articles on depression. There is a separate section which contains recent news articles on depression. A new article appears to be posted roughly every one to five days.
The “Progress Tracker” section of the app enables users to track their symptoms and activities. When defining a symptom, the user must specify the name of the symptom, as well as the type of data they wish to capture about it. A similar approach is taken for tracking activities. Thus, the app does not contain a default set of trackers, but instead is designed to be configurable to track everything. Although the flexibility may be useful for some users, others may find it confusing that the app is not ready to use without configuration. Finally, the “Reports” feature enables users to see trends in the data reported in the “Progress Tracker”.
Ease of Use and User Experience
Anti-Depression is a native iOS app and runs without error. When launched, the app greets users with a button which can be used to view the instructions. Users are asked to register an account on SoundMindz.org before using the app. When users register on SoundMindz.org, they are asked to supply their name, email address, country, ZIP code, sex, and date of birth. This highly personal information does not appear to be utilized within the app.
The use of the diagnostic in the “Assess” component of the app is intuitive, and directly leads the user to useful content as the assessment is unfolding. There are audio recordings of each of the questions on the assessment so that users unable to read may hear them. Nonetheless, selecting responses requires the ability to read. Nonetheless, there is more room for improvement in the other sections of the app. It is unclear why the “Resources” section allows users to listen to the audio recordings of the questions. Likewise, the “Progress Tracker” is a bit unintuitive to use and requires configuration before it may be used to capture data.
The app was tested on an iPhone 5S and an iPhone 6S, and rescaled appropriately to fit the dimensions of the screens of both devices. The user interface consists largely of text, accompanied by radio buttons for responding to the assessment. The progress tracker allows users to customize the data types being tracked, and thus different users will experience different user interfaces in the progress tracker. The app has sparse graphics, and reports are not presented graphically.
Appropriateness of Content
The app is very adaptive – almost too adaptive. Appropriate content is presented as needed while the user answers the assessment. This may distract some users from the process of completing the assessment. The “Progress Tracker” is a blank slate, and thus can be configured to meet the needs of any user. That being said, the app is intended to be appropriate for those facing depression.
Appropriateness of Feedback
Feedback is provided instantly throughout the assessment process, and directly relates to the previous question answered. Thus, feedback is highly personalized and rapidly delivered.
The cognitive challenge provided by the app comes in completing the activities proposed during and at the end of the assessment. The app provides the user a week’s worth of homework at the end of the assessment. Some of the homework can be completed by tracking things with the tracker, while other elements of it involve substantial introspection.
Ease of Account Management
The app does not appear to contain any means for account management. Users are asked to input their age and gender each time they take the assessment. It is unclear why this happens, as this information is required to be provided when users launch the app and establish an account on SoundMindz.org. While the entries in the “Progress Tracker” are intended to be synced between the app and SoundMindz.org, in testing, this did not occur. As the app offers no means of logging in or out of a user account, it was not possible to determine if this issue was account-specific.
Dr. Arthur Ciaramicoli, a licensed clinical psychologist and the Chief Medical Officer of SoundMindz, was involved in the development of the app and wrote its introductory letter as well as the contents of its eBook. While the app makes vague references to scientific research in various places, citations are not provided. Citations to the scientific literature or mentions of formal testing of the app have not been posted on SoundMindz.org either. Likewise, the news feature pulls recent articles into the app, although their origins are unclear.
Qualitative Review of Program Efficacy
The program contains useful content, but is only likely to be efficacious in individuals persistent enough to use it and to complete the various activities suggested throughout the assessment and at the conclusion of the assessment. Unfortunately, activity recommendations are not stored for later review as users progress through the assessment. As a result, it may be difficult for some to capture everything which is recommended and to act upon it. The tracking components of the app likewise require a highly motivated user, as they must be configured to be functional.
Estimate of Efficacy Relative to Similar Products
There are a number of tools for helping people manage depression. Given that the app does not provide users with a set of activities to complete in an easy to retrieve fashion (recommendations are each only shown once as users progress through the assessment) and that the tracking tool requires complete customization, the app may be less efficacious than alternatives. However, the frequent addition of content to the app through the news feature may drive people to return to the app over time, even after they have initially viewed all of the content.
The app is free.