Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis

Abstract

BackgroundThe majority of internet-based anxiety and depression intervention studies have targeted adults. An increasing number of studies of children, youth, and young adults have been conducted, but the evidence on effectiveness has not been synthesized. The objective of this research is to systematically review the most recent findings in this area and calculate overall (pooled) effect estimates of internet-based anxiety and/or depression interventions.MethodsWe searched five literature databases (PubMed, EMBASE, CINAHL, PsychInfo, and Google Scholar) for studies published between January 1990 and December 2012. We included studies evaluating the effectiveness of internet-based interventions for children, youth, and young adults (age <25 years) with anxiety and/or depression and their parents. Two reviewers independently assessed the risk of bias regarding selection bias, allocation bias, confounding bias, blinding, data collection, and withdrawals/dropouts. We included studies rated as high or moderate quality according to the risk of bias assessment. We conducted meta-analyses using the random effects model. We calculated standardized mean difference and its 95% confidence interval (95% CI) for anxiety and depression symptom severity scores by comparing internet-based intervention vs. waitlist control and internet-based intervention vs. face-to-face intervention. We also calculated pooled remission rate ratio and 95% CI.ResultsWe included seven studies involving 569 participants aged between 7 and 25 years. Meta-analysis suggested that, compared to waitlist control, internet-based interventions were able to reduce anxiety symptom severity (standardized mean difference and 95% CI = −0.52 [−0.90, −0.14]) and increase remission rate (pooled remission rate ratio and 95% CI =3.63 [1.59, 8.27]). The effect in reducing depression symptom severity was not statistically significant (standardized mean difference and 95% CI = −0.16 [−0.44, 0.12]). We found no statistical difference in anxiety or depression symptoms between internet-based intervention and face-to-face intervention (or usual care).ConclusionsThe present analysis indicated that internet-based interventions were effective in reducing anxiety symptoms and increasing remission rate, but not effective in reducing depression symptom severity. Due to the small number of higher quality studies, more attention to this area of research is encouraged.Trial registrationPROSPERO registration: CRD42012002100

Attitudes Toward e-Mental Health Services in a Community Sample of Adults: Online Survey

“…A variety of services fall under the term e-mental health, including mental and behavioral health promotion, prevention, treatment and management-oriented interventions that are delivered via the Internet or other electronic technologies, with or without human support [6]. A number of meta-analyses have now shown these services to be comparable to face-to-face options in their effectiveness in treating mental illness [7][8][9].…”

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“…In a meta-analysis evaluating the effectiveness of Internet-based interventions of children, youth and young adults with anxiety and/or depression and their parents, Internet-based interventions were able to reduce anxiety symptom severity and increase remission rate, but not effective in reducing depression symptom severity [3]. The study also found no statistical difference in anxiety or depression symptoms between Internet-based intervention and face-to-face intervention.…”

“…Interventions can range from generic psychoeducational static webpages to complex and personalized computer-based cognitive behavioral therapy (CBT) program delivered via self-help session with and without online and/or face-to-face support from healthcare professionals [1,2,3]. CBT is a form of talking therapy that focuses on how an individual thinks about himself/herself, the world and other people ('cognitive') and what the individual does affect his/her thoughts and feelings ('behavior') [4].…”

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