Preliminary efficacy of a self-guided mobile intervention for reducing stress in depression: A randomized controlled crossover trial.
Junhyung Kim, Seung-Hoon Lee, Cheolmin Shin, Kyu-Man Han, Sang-Won Jeon, Changsu Han
Journal of Affective Disorders June 17, 2026 DOI: 10.1016/j.jad.2026.122143 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled crossover pilot trial Pilot study Peer reviewed |
|---|---|
| Sample size | 39 |
| Population | Adults with mild-to-moderate major depressive disorder undergoing pharmacological treatment |
| Intervention | relaxation audio |
| Duration | 4-week intervention |
| Measures | Depression Anxiety Stress Scales-Stress subscale (DASS-Stress) |
| Topics | Depression Meditation |
| Keywords | Humans Treatment outcome Pilot projects Cross-over studies Stress, psychological Adult Middle aged Female Mobile applications Cognitive behavioral therapy Subjective stress Stress reduction Digital health intervention |
| Key findings | The inMind digital intervention was associated with a reduction in DASS-Stress scores (estimate = -2.41), narrowly exceeding the published minimum clinically important difference, with directionally consistent reductions in depressive and anxiety symptoms. The authors report that significant carry-over effects complicated causal interpretation, and that usage metrics showed no significant association with outcomes. |
Abstract
Stress worsens clinical outcomes in patients with major depressive disorder (MDD); however, timely accessible stress management tools remain limited. Digital interventions offer scalable adjunctive solutions early during pharmacological treatment. In this multicenter, assessor-blinded, randomized controlled crossover pilot trial, we conducted a preliminary evaluation of the short-term efficacy of a self-guided digital health intervention (inMind) in reducing psychological stress in individuals with mild-to-moderate MDD undergoing pharmacological treatment. We randomly assigned 39 participants to the App-first or Delayed-app sequence, with 36 analyzed. inMind comprised cognitive-behavioral therapy and mindfulness-based stress-reduction modules, relaxation audio, and heart-rate-variability-based stress monitoring. The primary outcome was change in the Depression Anxiety Stress Scales-Stress subscale (DASS-Stress), with secondary measures of depression, anxiety, and perceived stress. Analyses followed a modified intention-to-treat approach using linear mixed-effects models. The inMind condition was associated with a reduction in DASS-Stress (estimate = -2.41; p = 0.047), narrowly exceeding the published minimum clinically important difference, with directionally consistent reductions in depressive and anxiety symptoms. Significant carry-over effects complicated causal interpretation under the no-washout design. Usage metrics showed no significant association with outcomes, consistent with a low-intensity, flexible intervention. Adherence was high in both groups. These preliminary findings suggest that inMind, a 4-week self-guided digital adjunct, may produce modest short-term reductions in stress, depression, and anxiety alongside pharmacotherapy in mild-to-moderate MDD; if confirmed in adequately powered trials, such tools may complement pharmacotherapy and inform future digital adjuncts.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cites 7
- Digital Meditation to Target Employee Stress: A Randomized Clinical Trial. JAMA Network Open January 2, 2025
- The Effects of Mindfulness-Based Stress Reduction on Negative Self-Representations in Social Anxiety Disorder—A Randomized Wait-List Controlled Trial Frontiers in Psychiatry May 12, 2021
- Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial PLoS One January 7, 2021
- The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review Mindfulness September 24, 2020
- The effects of mindfulness‐based stress reduction on depression, anxiety, and stress in older adults: A systematic review and meta‐analysis International Journal of Mental Health Nursing January 17, 2019
and 2 more in the library