Digital health interventions find a link between symptoms of anxiety and depression

A digital health intervention provided via a smartphone showed that current anxiety symptoms predict both current and later depressive symptoms.

In a 12-week, therapist-supported digital health intervention provided by a smartphone for symptoms of anxiety and depression, the researchers found that the symptoms of the two conditions overlapped and varied together.

The intervention also showed that anxiety symptoms predict later depressive symptoms more strongly than depressive symptoms that predict anxiety symptoms.

These findings are published in Journal of Clinical Psychology.

The study included 290 participants, mostly women (79%) with a mean (SD) age of 39.64 (10.25) years. The authors of the study note that more than half (54%) of patients stated that they had used psychotropic drugs. In addition, all patients received at least 5 on either the Patient Health Questionnaire (PHQ-9) or the Generalized Anxiety Questionnaire (GAD-7).

Smartphone-based intervention includes a predefined sequence of evidence-based modules integrating components of attention-based stress reduction and cognitive therapy, cognitive-behavioral therapy, and training in biological feedback on heart rate variability (HRVB).

The authors used linear mixed models to analyze both concomitant and the relationships between anxiety and depression.

In one hypothesis, the authors predict that the increase in anxiety will be associated with an increase in depression this week. In the second hypothesis, they also predict that the increase in anxiety in the previous week will be followed by an increase in depression in the current week.

In support of the first prognosis, the authors found that higher levels of anxiety during the current two-week assessment were associated with greater depressive symptoms during the current two-week assessment.

In support of the second hypothesis, higher levels of anxiety during the previous two-week assessment were associated with greater depressive symptoms during the current two-week assessment.

“Our results, limited by the lack of a comparison group, are consistent with daily data on these alarming symptoms at a given time. T-1 were a stronger predictor of depressive symptoms in time T than depressive symptoms in time T-1 predict anxiety levels at a time T“, Said the authors.

The authors also note that these results are “far from convincing, but raise a number of questions”, adding that future studies will be useful in analyzing the effects of mediators and moderators of anxiety on subsequent depressive symptoms and some emotional effects of reducing depression. anxiety.

Third, it would be important to study specific GAD-7 elements that predict subsequent reductions in depression, such as nervousness and nervousness, anxiety about a number of events, difficulty coping with anxiety, difficulty relaxing, irritability, and fear of a negative event occurring. future, “they added.

In addition, due to the link between anxiety and depression, changing weekly treatment approaches based on changing levels of anxiety and depression may benefit patients more than the structured approach adopted in this particular intervention.

“For example, if a patient’s anxiety is higher than depression in a given week, the patient may benefit from psychoeducation about the cyclical nature of anxiety and depression and from working with the clinician to develop skills to mitigate any impending mood swings.” , the authors suggest.


Allende S, Forman-Hoffman VL, Goldin PR. Study of the temporal dynamics of anxiety and depressive symptoms during a therapist-supported smartphone-based intervention for depression: a longitudinal observational study. J Clin Psychol. Published online on June 10, 2022 doi: 10.1002 / jclp.23401

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