Efficacy of Internet-Based Cognitive Behavioral Therapy for Depression and Anxiety among Global Population during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of a Randomized Controlled Trial Study

Abstract

Background: Depression and anxiety have become the most common mental health disorders worldwide during the COVID-19 pandemic, and increasing interest in telemedicine has led to the innovation of using internet-based cognitive behavioral therapy (iCBT). Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of iCBT for depression and anxiety among the global population during the COVID-19 pandemic. Methods: A literature search was conducted on PubMed, Scopus, Cochrane, ProQuest, Wiley, and Web of Science using the PRISMA framework, and only randomized controlled trials (RCTs) were included in the study. A critical appraisal was also performed using Cochrane’s Risk of Bias (RoB) 2. The meta-analysis used random-effects models to analyze pooled mean difference (MD) and its p-value. Results: Twelve RCTs were included for qualitative analysis and nine RCTs, which yielded 6778 patients with depression and 6556 patients with anxiety during the COVID-19 pandemic, were included for quantitative analysis. Despite high heterogeneity, all studies had a low risk of bias. Pre- and post-iCBT intervention in the depression forest plot depicts a significant effect (p < 0.00001) with a pooled MD of 4.73 (95% CI: 4.55–4.90), while the pre- and post-iCBT intervention depicts a significant effect (p < 0.00001) with a pooled MD of 4.50 (95% CI: 4.34–4.67). This demonstrates that iCBT was found to significantly decrease depression and anxiety scores in patients during the COVID-19 pandemic. However, substantial heterogeneity was also found (I2 = 93%; p < 0.00001 and I2 = 90%) for the pre-/post-depression and anxiety forest plots, respectively. Conclusions: This meta-analysis comprises an evidence-based result for iCBT to treat depression and anxiety in the COVID-19 population, as indicated by the significantly lower assessment scores. Delivering iCBT in this situation needs to be considered more extensively, as it has promising results and yields the benefits of technological advancement in psychotherapy.

Telemedicine Interventions as an Attempt to Improve the Mental Health of Populations during the COVID-19 Pandemic—A Narrative Review

“…However, they have indicated that the available literature highlights the problem of availability of IT equipment and internet access to include support for broader target groups [ 24 ]. Similar findings were reported by Komariah et al [ 40 ]. A systematic review along with a meta-analysis assessed the effectiveness of iCBT in treating depression (6778 patients) and anxiety (6556 patients) among global populations.…”

“…Adherence to remote programmes has previously been shown to be at a high level. On the other hand, it has been shown that clinician-guided delivery is more acceptable than self-guided intervention [ 40 , 41 ]. Recent systematic reviews have shown that videoconferencing interventions delivered by health care professionals are effective in improving anxiety and depression in adults when delivered live and one-on-one [ 42 , 43 ].…”

Academic stress and depression among vietnamese adolescents: a moderated mediation model of life satisfaction and resilience

“…Therefore, online psychotherapies may be essential for improving mental health issues in the context of COVID-19, such as cell phone interventions. In the literature, some online psychotherapies have been used such as mobile phone interventions (mHealth apps) (Tran et al, 2018 ), Internet-Based Cognitive Behavioral Therapy (Komariah et al, 2022 ); digital cognitive behavioural therapy (Soh et al, 2020 ). Online psychotherapies may be feasible and have great promise in reducing mental health problems in adolescents.…”

Atendimentos em psicoterapia na pandemia de Covid-19 e seu impacto na atenção básica: uma análise retrospectiva

“…Para minorar os efeitos deletérios da ausência de atendimento psicoterapêutico, sobretudo num período com aumento agudo de ansiedade (KOMARIAH et al, 2022) e depressão (KUBON et al, 2021), como é uma pandemia, houve rápido desenvolvimento do atendimento à distância, a chamada telessaúde. Tanto por parte dos profissionais médicos, quanto por parte dos profissionais da psicologia.…”