Mitigating COVID-19-Related Depression: A Meta-Analysis of Cognitive Behavioral Therapy Efficacy with Subgroup Analysis

Abstract

Background Amidst the global prevalence of COVID-19, depression has emerged as a leading mental health concern, underscoring the urgent need to address psychological distress during this public health crisis. Despite its widespread impact, there is a notable dearth of research focusing on interventions tailored specifically for COVID-19 patients. Objective Against the backdrop of the COVID-19 pandemic's profound effect on mental health, particularly concerning depression, this study aims to evaluate the efficacy of cognitive behavioral therapy (CBT) in mitigating psychological distress among individuals affected by COVID-19. Method A comprehensive literature search was conducted across multiple databases, including PubMed, Google Scholar, ScienceDirect, Crossref, and Web of Science, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for analysis. Cochrane's Risk of Bias (RoB) tool was utilized to ensure rigorous evaluation. Subgroup meta-analysis was employed to explore variations in treatment effects among different demographic or clinical subgroups, including factors such as country of origin, age groups, duration of therapy sessions, and baseline assessment scores. A random-effects model was utilized to assess the standard deviation from the mean (SMD) and its associated p-value for meta-analysis. Results A total of 30 RCTs were included in the analysis, comprising 12,428 depression patients during the COVID-19 pandemic. Subgroup analysis revealed significant variations across countries. Despite differences, all studies demonstrated low bias risk. The forest plot indicated a significant reduction in depression scores post-CBT intervention (p = 0.0002, SMD: 1.27, 95% CI: 0.61; 1.93). Subgroup analyses based on therapy duration and assessment methods showed consistent reductions in depression scores across different lengths of therapy and assessment tools: 6-week (SMD: -0.09 [-0.32; 0.14]), 8-week (SMD: -0.26 [-0.74; 0.22]), 1-week (SMD: -0.09 [-0.21; 0.03]), 2-week (SMD: 0.04 [-0.11; 0.19]), and 12-week (SMD: -0.14 [-0.27; -0.01]). These results highlight CBT's efficacy in managing COVID-19-related depression. Conclusions CBT significantly reduces depression scores among individuals with COVID-19-related depression, highlighting its effectiveness across diverse populations and treatment durations.