Short-term effect of a smartphone application on the mental health of university students: A pilot study using a user-centered design self-monitoring application for mental health

Kosuke Kajitani, Ikumi Higashijima, Kosuke Kaneko, Tomoko Matsushita, Hideaki Fukumori, Daewoong Kim, Kosuke Kajitani, Ikumi Higashijima, Kosuke Kaneko, Tomoko Matsushita, Hideaki Fukumori, Daewoong Kim

Abstract

Background: Despite the widespread recognition of the importance of mental health in young people, only a small proportion of young people with a mental disorder, including university students, receive mental health care.

Objective: We developed a smartphone application (Mental App) for the university students and examined the effects of the app on their mental health.

Methods: The app was designed according to a questionnaire survey conducted before this study. The Mental App was installed on the students' smartphone and the psychological tests (the Link Stigma Scale, the Center for Epidemiologic Studies Depression Scale, and the 12-item General Health Questionnaire) were performed on the same day. After using the App for two weeks, the students completed a questionnaire survey and underwent the same psychological tests. We compared the results between the app user and non-user group.

Results: A total of 68 students participated, of which 57 students completed the study (app user group, n = 28; control group, n = 29). The mean number of days spent using the app was 5.66 ± 3.16 (mean ± SD). The mean total screen time of the app was 9:03 ± 06:41(min:sec). The mean number of total actions (screen taps or swipes) was 161.91 ± 107.34. There were no significant between-group differences in the ΔLink Stigma Scale score (-0.11 ± 4.28 vs. -0.59 ± 3.30, p = 0.496) or the ΔCenter for Epidemiologic Studies Depression Scale score (-4.39 ± 7.13 vs. -2.07 ± 8.78, p = 0.143). There was a significant between-group difference in the ΔGeneral Health Questionnaire score (-2.21± 2.23 vs. -0.17 ± 2.69, p = 0.007).

Conclusions: This non-randomized controlled pilot study indicates that the app we developed, may provide effective mental health care for university students, even in the short-term. Trial registration: UMIN000040332.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flowchart of the recruitment process…
Fig 1. Flowchart of the recruitment process and the study design.
Fig 2. Screenshots of Mental App.
Fig 2. Screenshots of Mental App.
Since the app is only available in Japanese, English captions are shown in the screenshots. (A) The Mental App icon. A magnified view is also shown. (B) The main screen of the record function. A calendar system was used to record daily conditions. Users can tap the date to record the conditions of that day. (C) Recording daily conditions. The screenshot shows a screen asking about users’ appetite for the day. Users choose the extent of their appetite by tapping the corresponding button. Users can swipe the screen to go to the next question. (D) The summary of the conditions of the day. In the record function, users can record their daily appetite, exercise, sleep time, and mood. (E) The main screen of the screening function for mental disorders. Users can start the screening test for mental disorders. (F) Example of the screening test. The screenshot shows the screening test for depression. (G) Results of the screening test. If the screening test was positive, more detailed tests for each disorder were offered to determine the severity. (H) Assessment of the severity of each mental disorder. According to the severity, the app offered the users advice and information (e.g., the contact information of the campus clinic or the nearest clinics, the website of campus clinic, a self-care website, and contact information of public consulting services). Furthermore, users could learn about each disorder by tapping the blue button.
Fig 3. Histograms of log data.
Fig 3. Histograms of log data.
(A) Histogram of days spent using the app. (B) Histogram of screen time of the app. (C) Histogram of the total number of actions (screen taps or swipes).
Fig 4. Comparison of the difference in…
Fig 4. Comparison of the difference in the psychological test scores before and after the intervention (Δvalue) between app users and non-users.
(A) There was no significant difference in the Δvalue of the LSS score (ΔLSS) between the app user and non-user groups (p = 0.496). (B) There was no significant between-group difference in the Δvalue of the CES-D score (ΔCES-D; p = 0.143). (C) Comparison of the Δvalue of the GHQ-12 (ΔGHQ-12) between the app user and non-user groups. The app user group showed a significantly greater difference score than that of the non-user group (p = 0.007). Mann-Whitney U test, *p < .05.

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