UOC research team develops method to evaluate apps for treating depression

Diagnoses of depression, one of the most common mental disorders, increased by nearly 50% between 1990 and 2017, according to data from the World Health Organization (WHO). Currently, depression affects around 5% of the world's population. In Catalonia, the number of people diagnosed with the condition has also risen significantly in recent years. Between 2017 and 2022, the figures for depression and mood disorders grew by 86.6%, as reported by Catalonia's public network of primary healthcare centres.

New technologies to treat this disorder, mainly mobile apps, have proven highly effective when used in conjunction with face-to-face psychological interventions, and help relieve the high care burden on health systems. The challenge is ensuring the quality of these mobile apps, as most of them are not based on scientific evidence and there is no guarantee they can effectively treat patients.

A team from the eHealth Lab research group at the Universitat Oberta de Catalunya (UOC) has carried out a study to identify the most important criteria for patients when using apps for the treatment of depression. The goal of this research is to develop a digital solution, to be called EvalDepApps, that will evaluate apps for managing depression and help patients and health professionals to choose the most appropriate tool to support their treatment. The study, Validation and selection of criteria for evaluating apps for managing depression: a Delphi study, has been published in the British Medical Journal and received funding from Spain's National RDI Plan.

"Just as we evaluate a drug or a medical product before it reaches the market to ensure its efficacy and safety, any apps we use to take care of our health and well-being must also be evaluated to determine their effects, and we're not currently doing enough of this. These apps can have a potential impact on public health, and can even be harmful in some cases," said Carme Carrion, project leader and principal investigator at the UOC's eHealth Lab.

The aim of the EvalDepApps project is to develop a tool that will evaluate and validate apps for depression based on scientific evidence, thereby responding to the needs of patients who use them. This tool, which will also be a mobile app, will give users clear indications to help them choose an app for treating depression that suits their individual needs and preferences.

Efficacy, safety and usability, the most important criteria

The project's researchers catalogued current depression apps and analysed around 30 of them. Their findings showed that only eight were supported by published scientific evidence. To determine the most relevant criteria for users, 43 individuals were surveyed using a Delphi process, a prospective method to evaluate how important experts consider each aspect to be.

The criteria prioritized by users when choosing an app were data safety, clinical efficacy, whether it was supported by evidence and whether the technology was intuitive and easy to use. Users also preferred apps that enable interaction, facilitate emergency contact with mental health professionals or the health system, and form part of a therapeutic package, meaning they are not used in isolation or without the support of health professionals.

For Carrion, it is vital to establish an app's main purpose: "This point is key because, otherwise, we tend to try and build too many things into an app and then it becomes unusable. The saying 'less is more' is spot on here." One of the most sensitive challenges relating to apps for the treatment of depression is privacy. This was one of the aspects most highly prioritized by people living with depression and health professionals who participated in the study. "It's vital to consider the target group for each app, especially in terms of privacy," Carrion explained.

Another point that users highlighted was the app's ability to track the patient's clinical progress. Noemí Robles, a member of the Research Methods & Data Science Lab and a researcher involved in the EvalDepApps project, explained that it "can help the person to be more aware of their own emotional state and to monitor it more personally, provided this information is shared with the professionals who care for them. It can be highly valuable information, especially if the apps are able to detect mood swings or situations in which the patient may be at risk, so that extra support could be offered to the user."

Another key aspect that emerged during the study was whether or not the app applies the gender perspective to the treatment of depression, given that men and women tend to have different symptoms. For example, women are more likely to feel sadness or guilt, while in men depression is expressed more through irritability.

People-led app design

Another aspect highlighted by the eHealth Lab researchers is that end users should play a leading role in app development , from the beginning to the end of the creative process: "We must learn to take users' views into account and understand that the process does not end until the app has been tested by users. Sometimes, even when the app is created jointly, what seems valid on paper does not work in practice. It's important, therefore, for the development team to bear in mind that they may have to make changes after the first tests," said Carrion, who is also a member of the UOC's Faculty of Health Sciences.

The next step for the EvalDepApps project is to recruit participants to carry out a pilot test that allows users to try out the tool. Once it has been validated, the app will be available to people living with depression to guide them when choosing the technological tools that can support them as part of their treatment plan. Although the tool is not intended for developers, the researchers note that it could also be useful for them to know what aspects matter most to users and incorporate them into the design of their apps.

The UOC's eHealth Centre, an internationally recognized centre of excellence in digital health research, is currently working on other projects in the field of health and new technologies, such as improving digital skills for oncology professionals, developing online interventions for breast cancer sufferers and pre-menopausal women, and the evaluation of an AI-based app for the WHO to better train primary care professionals in the diagnosis of skin diseases.

This research aligns with the UOC's Ethical and human-centred technology mission and is part of the EvalDepApps project to develop a tool for the evaluation of mobile applications aimed at managing depression, funded by the Carlos III Health Institute of the Spanish Ministry of Science, Innovation and Universities, and contributes to UN Sustainable Development Goal (SDG) 3: Ensure healthy lives and promote well-being for all at all ages.

Related article

Robles N, Fuster-Casanovas A, Moretó S, et a Validation and selection of criteria for evaluating apps for managing depression: a Delphi study BMJ Open 2025;15:e101302. doi: 10.1136/bmjopen-2025-101302

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