A New Way to Confront Depression

February 05, 2012

GW psychiatrist creates mobile app to treat depression.

Depression is the number one cause of disability worldwide, affecting one out of every eight people.

Because they are most comfortable with their primary care providers, about 70 percent of people see these providers to treat their depression. But most primary care providers lack the training to adequately treat the condition.

That's why Daniel Z. Lieberman, professor of psychiatry and behavioral sciences, created a mobile app to help patients get what they need from their primary care providers.

“Many patients who see their primary care providers receive antidepressant doses that are too low. They don’t have enough follow-up visits, and they end up not getting treated long enough.” said Dr. Lieberman. “If you give the app to the physician, the physician isn’t going to use it. We know that so there’s no point in giving doctors more tools. So we’ve developed a new kind of solution – a tool for patients.”

The smartphone app, which is named Best Practice Depression, has patients fill out a brief questionnaire before each visit to their primary care doctor. The questionnaire is a standardized tool to rate the severity of depression. As patients get prescribed medication, they enter the dosage amount into the app. The app tracks the patient’s progress and provides best practice guidelines and patient education for the individual’s depression. As patients prepare to go to a follow-up appointment with their primary care provider, they take another patient health questionnaire. The app then tells them if they’re making adequate progress and makes suggestions for what to talk to the doctor about.

“The app is not designed to tell the doctor what to do. It’s designed to be a conversation starter,” said Dr. Lieberman. “But we know that doctors respond to patient requests.”

In order to be diagnosed with depression, patients have to be experiencing depressed moods or loss of interest in their surroundings for at least two weeks and have additional symptoms such as loss of appetite, difficulty sleeping, low energy, difficulty concentrating or thoughts of death.

“Major depressive disorder is a very serious illness that’s a major public health problem,” Dr. Lieberman said.

When patients are treated by their primary care providers for physicians, the patients are often told to come back in six months. But the depression needs to be accessed regularly to determine if the condition is improving.

“We need to see if the patient is responding to treatment or if the treatment needs to be modified,” he said.

Dr. Lieberman, who is interested in technological solutions for behavior health problems, got the idea for the mobile app while he was sitting in grand rounds last year listening to a lecture about depression.

“It occurred to me that the solution was to stop targeting the doctor and put the tool in the hands of the patient,” he said.

To design the app, Dr. Lieberman created the start-up company Best Practice Care along with GW psychiatry resident Sarah Keiser and three others including a computer programmer.

Dr. Lieberman plans to do a clinical trial for the app and have it out on the market later this year. He plans to sell the app to insurance companies, who can provide it to their members as part of their medical plan, and large clinics, which can offer it to their patients.

“We believe that this could have very widespread use,” he said.