Mind-body internet and mobile-based interventions for depression and anxiety in adults with chronic physical conditions: A systematic review of RCTs

Abstract

This review summarizes the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs) on depression and anxiety symptoms in adults living with chronic physical conditions. Six databases (MEDLINE, PsycINFO, SCOPUS, EMBASE, CINAHL, and CENTRAL) were searched for randomized controlled trials published from database inception to March 2023. Mind-body IMIs included cognitive behavioral therapy, breathwork, meditation, mindfulness, yoga or Tai-chi. To focus on interventions with a greater potential for scale, the intervention delivery needed to be online with no or limited facilitation by study personnel. The primary outcome was mean change scores for anxiety and depression (Hedges’ g). In subgroup analyses, random-effects models were used to calculate pooled effect size estimates based on personnel support level, intervention techniques, chronic physical condition, and survey type. Meta-regression was conducted on age and intervention length. Fifty-six studies met inclusion criteria (sample size 7691, mean age of participants 43 years, 58% female): 30% (n = 17) neurological conditions, 12% (n = 7) cardiovascular conditions, 11% cancer (n = 6), 43% other chronic physical conditions (n = 24), and 4% (n = 2) multiple chronic conditions. Mind-body IMIs demonstrated statistically significant pooled reductions in depression (SMD = -0.33 [-0.40, -0.26], p<0.001) and anxiety (SMD = -0.26 [-0.36, -0.17], p<0.001). Heterogeneity was moderate. Scalable mind-body IMIs hold promise as interventions for managing anxiety and depression symptoms in adults with chronic physical conditions without differences seen with age or intervention length. While modest, the effect sizes are comparable to those seen with pharmacological therapy. The field would benefit from detailed reporting of participant demographics including those related to technological proficiency, as well as further evaluation of non-CBT interventions. Registration: The study is registered with PROSPERO ID #CRD42022375606.

Association between Adverse Psychological Emotions and Postoperative Brace for Adolescent Idiopathic Scoliosis: A Prospective Cohort Study with Propensity Score Matching

“… 28 , 29 Single and cumulative adverse psychological emotions are significantly associated with reporting of chronic pain and pain‐related disability as an adult. 30 , 31 , 32 , 33 Therefore, we have reason to believe that measures which can effectively alleviate postoperative adverse psychological emotions may be beneficial to better clinical outcomes and quality of life.…”

Evolution of Primary Research Studies in Digital Interventions for Mental Well-Being Promotion from 2004 to 2023: A Bibliometric Analysis of Studies on the Web of Science

“…Self-guided internet- and mobile-based interventions based on common psychotherapeutic techniques can have small positive effects in reducing depression and smaller effects in reducing anxiety [ 13 ]. Without distinguishing between interventions that are self-guided and those that are minimally facilitated by expert personnel, moderate-in-magnitude effects on depression and anxiety have been found for internet and mobile-based interventions delivered to adults with chronic physical conditions [ 16 ]. Yet, studies are characterised by an overreliance on symptom measures, the limited assessment of comorbidities, and the relatively less frequent assessment of risk reduction and protective factors, which make the distinction between the three types of preventive approaches less clear [ 13 ].…”