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Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review

BACKGROUND: Electronic mental (e-mental) health care for depression aims to overcome barriers to and limitations of face-to-face treatment. Owing to the high and growing demand for mental health care, a large number of such information and communication technology systems have been developed in rece...

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Autores principales: Burger, Franziska, Neerincx, Mark A, Brinkman, Willem-Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997926/
https://www.ncbi.nlm.nih.gov/pubmed/31958063
http://dx.doi.org/10.2196/12599
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author Burger, Franziska
Neerincx, Mark A
Brinkman, Willem-Paul
author_facet Burger, Franziska
Neerincx, Mark A
Brinkman, Willem-Paul
author_sort Burger, Franziska
collection PubMed
description BACKGROUND: Electronic mental (e-mental) health care for depression aims to overcome barriers to and limitations of face-to-face treatment. Owing to the high and growing demand for mental health care, a large number of such information and communication technology systems have been developed in recent years. Consequently, a diverse system landscape formed. OBJECTIVE: This literature review aims to give an overview of this landscape of e-mental health systems for the prevention and treatment of major depressive disorder, focusing on three main research questions: (1) What types of systems exist? (2) How technologically advanced are these systems? (3) How has the system landscape evolved between 2000 and 2017? METHODS: Publications eligible for inclusion described e-mental health software for the prevention or treatment of major depressive disorder. Additionally, the software had to have been evaluated with end users and developed since 2000. After screening, 270 records remained for inclusion. We constructed a taxonomy concerning software systems, their functions, how technologized these were in their realization, and how systems were evaluated, and then, we extracted this information from the included records. We define here as functions any component of the system that delivers either treatment or adherence support to the user. For this coding process, an elaborate classification hierarchy for functions was developed yielding a total of 133 systems with 2163 functions. The systems and their functions were analyzed quantitatively, with a focus on technological realization. RESULTS: There are various types of systems. However, most are delivered on the World Wide Web (76%), and most implement cognitive behavioral therapy techniques (85%). In terms of content, systems contain twice as many treatment functions as adherence support functions, on average. Furthermore, autonomous systems, those not including human guidance, are equally as technologized and have one-third less functions than guided ones. Therefore, lack of guidance is neither compensated with additional functions nor compensated by technologizing functions to a greater degree. Although several high-tech solutions could be found, the average system falls between a purely informational system and one that allows for data entry but without automatically processing these data. Moreover, no clear increase in the technological capabilities of systems showed in the field, between 2000 and 2017, despite a marked growth in system quantity. Finally, more sophisticated systems were evaluated less often in comparative trials than less sophisticated ones (OR 0.59). CONCLUSIONS: The findings indicate that when developers create systems, there is a greater focus on implementing therapeutic treatment than adherence support. Although the field is very active, as evidenced by the growing number of systems developed per year, the technological possibilities explored are limited. In addition to allowing developers to compare their system with others, we anticipate that this review will help researchers identify opportunities in the field.
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spelling pubmed-69979262020-02-20 Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review Burger, Franziska Neerincx, Mark A Brinkman, Willem-Paul J Med Internet Res Review BACKGROUND: Electronic mental (e-mental) health care for depression aims to overcome barriers to and limitations of face-to-face treatment. Owing to the high and growing demand for mental health care, a large number of such information and communication technology systems have been developed in recent years. Consequently, a diverse system landscape formed. OBJECTIVE: This literature review aims to give an overview of this landscape of e-mental health systems for the prevention and treatment of major depressive disorder, focusing on three main research questions: (1) What types of systems exist? (2) How technologically advanced are these systems? (3) How has the system landscape evolved between 2000 and 2017? METHODS: Publications eligible for inclusion described e-mental health software for the prevention or treatment of major depressive disorder. Additionally, the software had to have been evaluated with end users and developed since 2000. After screening, 270 records remained for inclusion. We constructed a taxonomy concerning software systems, their functions, how technologized these were in their realization, and how systems were evaluated, and then, we extracted this information from the included records. We define here as functions any component of the system that delivers either treatment or adherence support to the user. For this coding process, an elaborate classification hierarchy for functions was developed yielding a total of 133 systems with 2163 functions. The systems and their functions were analyzed quantitatively, with a focus on technological realization. RESULTS: There are various types of systems. However, most are delivered on the World Wide Web (76%), and most implement cognitive behavioral therapy techniques (85%). In terms of content, systems contain twice as many treatment functions as adherence support functions, on average. Furthermore, autonomous systems, those not including human guidance, are equally as technologized and have one-third less functions than guided ones. Therefore, lack of guidance is neither compensated with additional functions nor compensated by technologizing functions to a greater degree. Although several high-tech solutions could be found, the average system falls between a purely informational system and one that allows for data entry but without automatically processing these data. Moreover, no clear increase in the technological capabilities of systems showed in the field, between 2000 and 2017, despite a marked growth in system quantity. Finally, more sophisticated systems were evaluated less often in comparative trials than less sophisticated ones (OR 0.59). CONCLUSIONS: The findings indicate that when developers create systems, there is a greater focus on implementing therapeutic treatment than adherence support. Although the field is very active, as evidenced by the growing number of systems developed per year, the technological possibilities explored are limited. In addition to allowing developers to compare their system with others, we anticipate that this review will help researchers identify opportunities in the field. JMIR Publications 2020-01-20 /pmc/articles/PMC6997926/ /pubmed/31958063 http://dx.doi.org/10.2196/12599 Text en ©Franziska Burger, Mark A Neerincx, Willem-Paul Brinkman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.01.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Review
Burger, Franziska
Neerincx, Mark A
Brinkman, Willem-Paul
Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title_full Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title_fullStr Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title_full_unstemmed Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title_short Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
title_sort technological state of the art of electronic mental health interventions for major depressive disorder: systematic literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997926/
https://www.ncbi.nlm.nih.gov/pubmed/31958063
http://dx.doi.org/10.2196/12599
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