Mobile app-based psychological interventions for depression and anxiety in primary care: A systematic review and meta-analysis

This systematic review and meta-analysis evaluated the effectiveness of mobile app-based psychological interventions in reducing distress (depressive and anxiety symptoms) and improving quality of life among adults in primary care (PC). We included randomized controlled trials (RCTs) involving adults with depression and/or anxiety identified through searches of PsycINFO, PubMed, Embase, and the Cochrane Library from database inception to April 11, 2025. Standardized mean differences (SMDs) and relative risks (RRs) were pooled using fixed- and random-effects models. Study quality was assessed using the Cochrane Risk-of-Bias 2 tool. Eleven RCTs ( N = 2915) met inclusion criteria, contributing 15 comparisons to the meta-analysis ( N = 2588; intervention vs. treatment as usual). Pooled analyses showed a significant reduction in overall distress (SMD = −0.44; 95% CI –0.68 to −0.21, p < 0.001) and a moderate decrease in depressive symptoms (SMD = −0.53, 95% CI –0.81 to −0.24, p < 0.001). Limited evidence from four comparisons showed no significant effect on anxiety (SMD = −0.25, 95% CI –0.68 to 0.18, p = 0.26). A small but significant improvement in quality of life was found (SMD = 0.16, 95% CI 0.06 to 0.25, p = 0.001). Participants using apps were more likely to drop out at post-treatment than controls (RR = 1.45, 95% CI 1.18 to 1.79, p < 0.001). Mobile app-based interventions appear to reduce distress and depressive symptoms and modestly improve quality of life in PC, although no significant effects were observed for anxiety. These findings support the potential role of app-based interventions as accessible tools within primary care. However, the limited and heterogeneous reporting of follow-up assessments restricts conclusions about the durability of these effects over time. Higher dropout rates also highlight the need to improve adherence strategies. • Mobile apps are associated with reductions in overall distress in primary care patients. • Mobile apps are associated with reductions in depressive symptoms. • Mobile apps yield small improvements in quality of life. • Participants in intervention groups were more likely to drop out than controls. • Limited and inconsistent follow-up reporting restricts conclusions about long-term effectiveness.