Two Novel Cognitive Behavioral Therapy-Based Mobile Apps for Agoraphobia: Randomized Controlled Trial

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). ©marina christoforou,josé andrés sáez fonseca,elias tsakanikos. originally published in the journal of medical internet research (http://www.jmir.org),24.11.2017.