A recent digital intervention utilizing mobile technology is being evaluated for its potential to reduce the incidence of common mental health disorders and their significant social and economic impact. Researchers are investigating whether a personalized approach delivered through a smartphone app can help prevent new cases of depression and anxiety, conditions that currently respond to treatment in only 30% to 50% of cases. This limited success is partly due to the fact that over 40% of all depression and anxiety cases each year are new occurrences, and existing treatments often fail to prevent their onset.
The study, known as PANDORA, is based on the premise that preventative measures are key. According to researchers, psychological and educational interventions, along with regular physical exercise, can prevent new cases of depression and anxiety in 20% to 40% of individuals at risk. Given that over 90% of adults now own mobile phones and access the internet via these devices, researchers believe the PANDORA intervention has the potential to reach millions of people in Spain and South America.
Depression and Anxiety in Spain
Depression and anxiety are the most prevalent mental illnesses. In Spain, approximately 2.5 million people suffer from depression, and another 2 million experience anxiety. In 2021, these conditions ranked second and eighth, respectively, among all physical and mental illnesses in terms of years lived with disability globally. Projections indicate that depression will become the leading cause of disability worldwide by 2030. Suicidal thoughts are common among individuals with depression, and nearly one million people die by suicide each year globally.
The impact of depression and anxiety extends beyond individual health. These conditions are particularly common among those of working age and are major contributors to work absences, often prolonged. Individuals with depression and anxiety experience reduced productivity and face significant challenges in securing or maintaining employment. The annual economic cost of depression and anxiety in Spain is estimated at 12 billion euros.
The PANDORA Project
Participation in the PANDORA study is currently open to any resident of Spain or Chile. Interested individuals can enroll through the study’s official website: https://pandorasalud.org/.
The study will follow all participants for one year, tracking the incidence of new cases of depression and anxiety. Participants will be randomly assigned to one of three groups: two intervention groups and a comparison group to evaluate the effectiveness of the PANDORA intervention.
The PANDORA intervention is delivered through a mobile app (available for both Android and iOS) and incorporates advice and exercises from four evidence-based areas known to be effective in preventing anxiety and depression: “increase physical activity,” “improve sleep,” “strengthen relationships,” and “enhance emotional wellbeing.” The app also includes risk calculators to predict the likelihood of developing depression or anxiety within the next 12 months. Prevention of depression and anxiety will be assessed at one, six, and twelve-month intervals.
The application will also identify individual risk factors for depression and anxiety, highlighting areas where preventative measures could be most effective. It will then automatically and personally suggest relevant content within the app to each user.
This plan is implemented by the user based on their motivation and available time, and the PANDORA app monitors progress and provides suggestions for further action as the risk of depression and anxiety increases. The app also allows users to filter content by topic, priority, duration (ranging from 2 to 10 minutes), and format (text, videos, quizzes, exercises).
“There are two versions of PANDORA,” explains Juan Bellón, a researcher with the RICAPPS network and project coordinator. “Both versions contain the same content, but are organized differently.” Some users will also be randomly assigned to the comparison group, which is essential for determining whether the PANDORA intervention effectively prevents depression and anxiety compared to no intervention.
