Computerised therapies for anxiety and depression in children and young people: A systematic review and meta-analysis

Abstract

One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.

Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial

“…In addition, samples of adolescents are overrepresented in unguided trials [18]. Both aspects are likely to influence meta-analytic comparisons, since less depressed samples and studies with adolescents tend to yield poorer outcomes in general [25,26]. Studies including experimental manipulation of guidance within otherwise equivalent treatments for depression are scarce and their results inconsistent: 2 studies comparing individualized e-mail therapy to guided standardized self-help yielded nonsignificant results [27,28].…”

Desired Features of a Digital Technology Tool for Self-Management of Well-Being in a Nonclinical Sample of Young People: Qualitative Study (Preprint)

“…While digital technology tools have been considerably promising for the management of mental health problems, such as anxiety and depression, in clinical youth populations [46,[48][49][50][51]] the efficacy of such tools is still unclear. Notably, studies into the effectiveness of digital technology tools in improving wellbeing in the non-clinical youth population have shown variable results or small effects [e.g.…”

“…Around 70% of young people own a mobile phone [43], with ownership increasing year-on-year [42] and saturation is nearly reached as more people than not have access to technology and the internet [45]. Although it is typically assumed that young people are 'ubiquitous users of digital technology' [47,48], the suitability and acceptability of digital technology tools have been questioned recognizing that they must be highly refined and specialised if they are going to be successful in assisting service care or, more importantly, in helping young people self-manage their wellbeing or mental health problems [47].…”

“…Around 70% of young people own a mobile phone [43], with ownership increasing year-on-year [42] and saturation is nearly reached as more people than not have access to technology and the internet [45]. Although it is typically assumed that young people are 'ubiquitous users of digital technology' [47,48], the suitability and acceptability of digital technology tools have been questioned recognizing that they must be highly refined and specialised if they are going to be successful in assisting service care or, more importantly, in helping young people self-manage their wellbeing or mental health problems [47].While digital technology tools have been considerably promising for the management of mental health problems, such as anxiety and depression, in clinical youth populations [46,[48][49][50][51] the efficacy of such tools is still unclear. Notably, studies into the effectiveness of digital technology tools in improving wellbeing in the non-clinical youth population have shown variable results or small effects [e.g.…”

Resultados preliminares do Programa PRHAVIDA em crianças com escores clínicos de ansiedade, depressão e estresse

“…A depressão na infância, normalmente, está associada à baixa autoestima, ao isolamento social, à queda no rendimento escolar e ao uso de substâncias (Martinsen et al, 2014;Meinzer et al, 2014). A depressão está presente cada vez mais na população infantil, podendo ser muitas vezes crônica, recorrente, causando prejuízos e limitações que estão associadas a consequências para toda vida (Pennant et al, 2015).…”