@Article{info:doi/10.2196/jmir.7747,
author="Christoforou, Marina
and S{\'a}ez Fonseca, Jos{\'e} Andr{\'e}s
and Tsakanikos, Elias",
title="Two Novel Cognitive Behavioral Therapy--Based Mobile Apps for Agoraphobia: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2017",
month="Nov",
day="24",
volume="19",
number="11",
pages="e398",
keywords="agoraphobia; anxiety; eHealth; computerized interventions; mobile applications; randomized controlled trial; RCT",
abstract="Background: Despite the large body of literature demonstrating the effectiveness of cognitive behavioral treatments for agoraphobia, many patients remain untreated because of various barriers to treatment. Web-based and mobile-based interventions targeting agoraphobia may provide a solution to this problem, but there is a lack of research investigating the efficacy of such interventions. Objective: The objective of our study was to evaluate for the first time the effectiveness of a self-guided mobile-based intervention primarily targeting agoraphobic symptoms, with respect to a generic mobile app targeting anxiety. Methods: A Web-based randomized controlled trial (RCT) compared a novel mobile app designed to target agoraphobia (called Agoraphobia Free) with a mobile app designed to help with symptoms of anxiety in general (called Stress Free). Both interventions were based on established cognitive behavioral principles. We recruited participants (N=170) who self-identified as having agoraphobia and assessed them online at baseline, midpoint, and end point (posttreatment) over a period of 12 weeks. The primary outcome was symptom severity measured by the Panic and Agoraphobia Scale. Results: Both groups had statistically significant improvements in symptom severity over time (difference --5.97, 95{\%} CI --8.49 to --3.44, P<.001 for Agoraphobia Free and --6.35, 95{\%} CI --8.82 to --3.87, P<.001 for Stress Free), but there were no significant between-group differences on the primary outcome (difference 0.38, 95{\%} CI --1.96 to 3.20, P=.64). Conclusions: This is, to our knowledge, the first RCT to provide evidence that people who identify as having agoraphobia may equally benefit from a diagnosis-specific and a transdiagnostic mobile-based intervention. We also discuss clinical and research implications for the development and dissemination of mobile mental health apps. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 98453199; http://www.isrctn.com /ISRCTN98453199 (Archived by WebCite at http://www.webcitation.org/6uR5vsdZw) ",
issn="1438-8871",
doi="10.2196/jmir.7747",
url="http://www.jmir.org/2017/11/e398/",
url="https://doi.org/10.2196/jmir.7747",
url="http://www.ncbi.nlm.nih.gov/pubmed/29175809"
}