- Design
- Randomised controlled trial
- Population
- 101 adult and older outpatients in psychotherapy for depression or anxiety
- Primary outcome
- Change in PHQ-9, GAD-7, SF-36 and working alliance
- Effect
- No significant difference in depression, anxiety or alliance; greater SF-36 pain improvement (n=65)
The EMAP randomised trial asked whether bringing patients' own digital communications into psychotherapy helps. Outpatients and partial-hospitalisation patients in therapy for depression or anxiety were randomised to usual care (49) or to electronic media-enhanced therapy (52), in which research staff screened consenting participants' text messages for personal mood-related terms and summarised the findings on a clinician dashboard before sessions.
Depression and anxiety scores did not improve significantly more with the dashboard, and the therapeutic alliance was neither helped nor harmed. Among the 65 participants with quality-of-life follow-up, the dashboard group improved more on the pain subscale. Clinicians who looked at the data more often took more clinical actions, but this did not translate into better outcomes.
The trial is small and short, and it tested one specific way of summarising messages. Still, it is a useful corrective: more collateral information changed what clinicians did without changing how patients fared.
- Adding text-message summaries to short-term therapy did not reduce PHQ-9 or GAD-7 scores in this trial.
- The therapeutic alliance was unaffected, which may reassure services weighing patient-consented data review.
- More collateral data led clinicians to act more, without better results, so extra information is not automatically better care.
- Any review of a patient's personal messages needs explicit, revisitable consent.
Why it matters
Digital phenotyping is moving into clinics faster than the evidence that it helps patients.
Don't overread it
The pain subscale gain was found in a subset with follow-up data and is not a reason to adopt the approach.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for psychiatry, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free