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

BMC Health Services Research

Karen Sutherland⁶  Margaret Synyshyn⁶  Jacqueline Angela Lemaire¹  Catherine Joan Charette⁴  Sara Adi Kreindler⁵  Colleen Metge⁵  Melissa Raynard³  Ashley Struthers⁴  Shannon Elizabeth Winters²  Sunita Bayyavarapu Bapuji⁴  Xibiao Ye⁵ 

[1] Addictions Foundation of Manitoba, 1031 Portage Avenue, Winnipeg, Manitoba R3G 0R8, Canada;Mental Health Crisis Response Centre, Winnipeg Regional Health Authority, 817 Bannatyne Avenue, Winnipeg MB R3E 0W4, Canada;Concordia Hospital Library, University of Manitoba, 1095 Concordia Avenue, Winnipeg, Manitoba R2N 3S8, Canada;Centre for Healthcare Innovation Evaluation Platform, Winnipeg Regional Health Authority, 200-1155 Concordia Avenue, Winnipeg, Manitoba R2K 2M9, Canada;Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;Manitoba Adolescent Treatment Centre, 120 Tecumseh St, Winnipeg, Manitoba R3E 2A9, Canada

关键词: Effectiveness;    Child and youth;    Depression;    Anxiety;    Internet-based intervention;   

Others  :  863959
DOI  :  10.1186/1472-6963-14-313

 received in 2013-12-18, accepted in 2014-07-10,  发布年份 2014

【 摘 要 】

Background

The 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.

Methods

We 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.

Results

We 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).

Conclusions

The 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 registration

PROSPERO registration: CRD42012002100

【 授权许可】

   
2014 Ye et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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