Smartphone App Reduces Depression in Adults With Intellectual Disabilities

A self-guided smartphone app designed for individuals with intellectual disabilities (IDs) significantly reduced depressive symptoms and improved self-esteem and quality of life, according to a clinical study conducted in Germany.¹

The findings from this randomized clinical trial (RCT) are published in JAMA Network Open.

“This is the first RCT, to our knowledge, to evaluate a smartphone-based self-help app for depressive symptoms in individuals with IDs,” wrote the researchers of the study. “The results address an important research gap and suggest that the study app offers promising and accessible mental health intervention for this underserved population.”

Depression is common among adults with IDs, yet it often goes underrecognized and undertreated.² Individuals with IDs may experience unique risk factors, including social isolation, communication barriers, stigma, and limited access to appropriate mental health care. Moreover, traditional therapeutic approaches can be difficult to adapt for this population, highlighting the need for tailored, accessible interventions. Therefore, improving mental health support for adults with IDs is essential to enhancing their overall well-being and quality of life.

In this study, adults with IDs and depressive symptoms were recruited online through social media, care institutions, and workplaces between April and August 2023.¹ Of the 135 individuals screened, 99 (mean [SD] age, 34.9 [12.6] years; 54.5% female) met eligibility criteria and were randomly assigned to either an intervention group using a self-help smartphone app or a waiting list control group. The app was based primarily on cognitive behavioral therapy techniques. Both groups continued receiving their usual care, which could include psychosocial support and general health services. Data on depressive symptoms, self-esteem, and quality of life were collected at baseline and after the intervention, and both complete case and intention-to-treat analyses were performed to evaluate outcomes.

In intention-to-treat analyses, participants in the intervention group experienced a greater reduction in depressive symptoms compared with the control group (F₁,₉₇ = 7.52; P = .007; ηp² = 0.072). The intervention group also showed significant improvements in quality of life (F₁,₉₇ = 5.09; P = .03; ηp² = 0.050) and self-esteem (F₁,₉₇ = 17.94; P < .001; ηp² = 0.156), with the latter demonstrating a large effect size. Of the 99 participants enrolled, 92 completed the postintervention assessment, and participants reported high satisfaction with the app.

However, the researchers acknowledged several limitations to their results, including reliance on self- or proxy reports, potential bias from separate randomization paths, and limited generalizability due to recruitment methods. Additionally, the waiting list design and lack of long-term follow-up restricted conclusions about sustained effects, and app use was self-reported rather than objectively tracked.

Despite these limitations, the researchers believe the trial highlights how digital, easy-to-read interventions can expand access to effective mental health support for individuals with IDs.

“Clarifying the optimal use of the intervention—whether as stand-alone, bridge, preventive, or maintenance support—will be essential for routine application,” wrote the researchers. “Clinical implementation studies should explore caregiver involvement, remaining accessibility barriers, and use outside research contexts. To reduce participation barriers in future studies, simplified language, visuals, and audio support should be standard. Support from caregivers or research staff and manageable survey length can further enhance participation. Preliminary field testing with the target group can help identify and address additional barriers.”

References

1. Borsutzky S, Paul LH, Rolvien L, et al. Self-help app for depression in people with intellectual disabilities. JAMA Netw Open. 2025;8(10):e2536364. doi:10.1001/jamanetworkopen.2025.36364

2. Hartley SL, Maclean WE. Depression in adults with mild intellectual disability: role of stress, attributions, and coping. Am J Intellect Dev Disabil. 2009;114(3):147-160. doi:10.1352/1944-7588-114.3.147