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Digital mental health
Longitudinal trends in the quality, effectiveness and attributes of highly rated smartphone health apps
  1. Mara Mercurio1,
  2. Mark Larsen2,
  3. Hannah Wisniewski1,
  4. Philip Henson1,
  5. Sarah Lagan1,
  6. John Torous1
  1. 1 Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2 Black Dog Institute, Randwick, New South Wales, Australia
  1. Correspondence to Dr John Torous, Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA; jtorous{at}


Background While there are numerous mental health apps on the market today, less is known about their safety and quality. This study aims to offer a longitudinal perspective on the nature of high visibility apps for common mental health and physical health conditions.

Methods In July 2019, we selected the 10 top search-returned apps in the Apple App Store and Android Google Play Store using six keyword terms: depression, anxiety, schizophrenia, addiction, high blood pressure and diabetes. Each app was downloaded by two authors and reviewed by a clinician, and the app was coded for features, functionality, claims, app store properties, and other properties.

Results Compared with 1 year prior, there were few statistically significant changes in app privacy policies, evidence and features. However, there was a high rate of turnover with only 34 (57%) of the apps from the Apple’s App Store and 28 (47%) from the Google Play Store remaining in the 2019 top 10 search compared with the 2018 search.

Discussion Although there was a high turnover of top search-returned apps between 2018 and 2019, we found that there were few significant changes in features, privacy, medical claims and other properties. This suggests that, although the highly visible and available apps are changing, there were no significant improvements in app quality or safety.

  • depression & mood disorders
  • schizophrenia & psychotic disorders

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Twitter @JohnTorousMD

  • Contributors All authors contributed equally.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. The goal of this project is not to call out any single app but rather note larger trends. It is possible to recreate these data for current apps with materials offered in the paper.