To evaluate the clinical efficacy of COMPASS, a therapist-supported digital therapeutic for reducing psychological distress (anxiety/depression) in people living with long-term physical health conditions (LTCs).

A two-armed randomized-controlled trial recruiting from LTC charities. Participants with anxiety and/or depression symptoms related to their LTC(s) were randomized (concealed allocation via independent administrator) to COMPASS (access to 11 tailored modules plus five thirty-minute therapist support sessions) or standard charity support (SCS). Assessments were completed online pre-randomization, at 6- and 12-weeks post-randomization. Primary outcome was Patient Health Questionnaire Anxiety and Depression Scale; PHQ-ADS measured at 12-weeks. Analysis used intention-to-treat principles with adjusted mean differences estimated using linear mixed-effects models. Data-analyst was blinded to group allocation.

194 participants were randomized to COMPASS (N = 94) or SCS (N = 100). At 12-weeks, mean level of psychological distress was 6.82 (95% confidence interval; CI 4.55–9.10) points lower (p < 0.001) in the COMPASS arm compared with SCS (standardized mean difference of 0.71 (95% CI 0.48–0.95)). The COMPASS arm also showed moderate significant treatment effects on secondary outcomes including depression, anxiety and illness-related distress and small significant effects on functioning and quality-of-life. Rates of adverse events were comparable across the arms. Deterioration in distress at 12-weeks was observed in 2.2% of the SCS arm, and no participants in the COMPASS arm.

Compared with SCS, COMPASS digital therapeutic with minimal therapist input reduces psychological distress at post-treatment (12-weeks). COMPASS offers a potentially scalable implementation model for health services but its translation to these contexts needs further evaluating.

NCT04535778

1. (1) To illustrate a digital treatment of OCD through flexible application of the current evidence base.

2. (2) To gain an understanding of the strengths and weaknesses of delivering digital out-patient CBT for OCD.

3. (3) To consider the utility of structured case reports in routine practice when delivering digital therapy.

In response to the treatment gap for anxiety and depressive disorders, psychological treatments with innovative modalities and high implementation potential are essential. Internet CBT (iCBT) is a cost/effective approach that could improve access to a low-intensity evidence-based CBT intervention.

To assess the feasibility and acceptability of the French adaptation of the physician-prescribed six-lesson This Way Up transdiagnostic iCBT program for mixed anxiety and depressive disorders developed in Australia.

Feasibility study with pre- post-intervention evaluations, including an embedded qualitative study in Family Medicine Groups (Quebec, Canada). Inclusion criteria comprise a family physician diagnosis of Major Depression, Panic Disorder, Agoraphobia, Social Anxiety Disorder or Generalized Anxiety Disorder. Primary self-reported outcomes: PHQ-9 (depression) and GAD-7 (anxiety); secondary measures include diagnostic-specific scales and health service utilisation.

Family physicians (N=21) from five Family Medicine Groups prescribed iCBT to 45 patients (30 women, 15 men; mean age = 39.7), 31 initiated the program. To date, 20 patients completed 5 or 6 lessons, nine completed between 2 and 4. Intervention and post-treatment assessments are ongoing, results forthcoming. Results of semi-structured interviews with patients (N=15) and family physicians (ongoing) on iCBT acceptability indicate it is beneficial, practical and easy to use. Program adherence requires patient readiness and determination and could be fostered by motivational support from clinicians.

Results support this French iCBT program’s scaling-up potential to contribute to reducing the gap in evidence-based treatments for common mental disorders. Its implementation in primary care could improve the effectiveness, efficiency and equity to a rapidly accessible treatment.

The Eye Movement Desensitization and Reprocessing (EMDR) therapy has shown to be useful in the treatment of PTSD, general anxiety, stress and burnout. Nonetheless, assessing therapy progress has been limited to subjective appreciations of the patient and therapist, which compromise therapy efficacy, and the continuum of care (clinic and at home) and scalability that digitized approaches can offer.

The aim of the present study was to validate the potential of a smartphone-based biofeedback digitized approach for EMDR usage in burnout therapy, as a means to provide quantitative progress assessment and personalized therapy optimization.

A digitized burnout status assessment app based on Maslach Burnout Inventory was first implemented and tested. Then, an EMDR app was developed by making use of adjustable audiovisual stimuli (e.g. different velocity and horizontal/vertical visual stimuli; and different pitch and left-right surround sound effects) and also of the smartphone’s camera photoplethysmography finger recordings from which heart rate, heart rate variability and breathing rate are derived and used for modulating stimuli (biofeedback). Finally, interviews with several EMDR experts were conducted to assess the potential of the app as a therapeutic adjuvant.

The preliminary interview results showed that the app can be useful for online therapy, to optimize the stimuli presentation, and to quantify the therapy experience and outcomes. The interviews also validated the technical specifications and usability of the tool.

Results so far have shown a promising receptivity and interest from EMDR experts. As such, patient testing is currently on-going.

The work of the present abstract is the basis of the research conducted at the Faculty of Sciences of the University of Lisbon, co-lead with NEVARO, a spin-off company of the same Faculty.