Smartphone App for Management of Mental Disorder: Comment on Usefulness in Specific Case of Posttraumatic Stress Disorder.

Sir,

Posttraumatic stress disorder (PTSD) is an important problem in psychological medicine that needs proper management. Math et al. noted that proper prevention and management of problem is very important and also mentioned that the good management is a “continuous and integrated cyclical process of planning, organizing, coordinating, and implementing measures to prevent and to manage disaster effectively.”[1] There are many new trials of using of Information Technology for management.[2] It is accepted as a possible way for “face to face but not in the same place” technique.[3] The use of smartphone app for management is very interesting.[4] As noted by Menon et al.,[4] “mobile phone-based psychotherapies are a feasible and acceptable treatment option for patients with mental disorders.” The application might useful for many psychological disorders including to PTSD. Here, we would like to make a more discussion on the specific situation, PTSD. Miner et al.firstly reported the new smartphone app namely “PTSD Coach app”[5] and reported on feasibility, acceptability, and potential efficacy for management of PTSD.[3] In an experimental trial by Kuhn et al. using smartphone app could significantly improve in PTSD symptoms. Kuhn et al. concluded that “given the ubiquity of smartphones, PTSD Coach may provide a wide reaching, convenient public health intervention for individuals with PTSD symptoms who are not receiving care.[6]” We agree that the use of smartphone app can be useful. Nevertheless, there are several considerations. First, the use of smartphone depends on the availability of the network. It is approved that the participants who used smartphone app could more successfully manage PTSD symptoms than those who did not. In a remote area, the network might not be available, and this is the same situation as “not use the smartphone app.” The app will be useless and not convenient in many areas without network. Of interest, a big disaster such as earthquake is usually related to the destruction of the communicable phone network. In that case, there are many people at risk for PTSD, but the smartphone app can be totally useless. That trial by Kuhn et al. cannot reflect the real PTSD situation.[6] No participants experienced that actual stress. In the period after stress, one who has the problem might not have time and money or lose the smartphone for downloading the smartphone app. Second, the cost of using app has to be mentioned. The smartphone app might be a hidden medical business that must be controlled. In addition, the privacy of the user of the app has to be protected. One who uses the app might be a person with a risk to have a psychological problem, the PTSD. During using the app, the registration is usually needed and this can be a way that the privacy can be invaded. Hence, his/her name has to be protected due to the privacy reason.[78] In the study by Kuhn et al.,[6] there might be a violation of privacy on “web-administered self-report.” In addition, the reliability of the reporting by web cannot be warranted. It can be seen that the applicable of a smartphone app for the case of PTSD is clinically sound, but there are several concerns. The availability and confidence of the system are important issues. Those concerns can also be the same for application of smartphone app for management of mental problem in other mental problems.

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Conflicts of interest

There are no conflicts of interest.