A2 Refereed review article in a scientific journal
Digital Interventions for the Treatment of Depression: A Meta-Analytic Review
Authors: Moshe Isaac, Terhorst Yannik, Philippi Paula, Domhardt Matthias, Cuijpers Pim, Cristea Ioana, Pulkki-Råback Laura, Baumeister Harald, Sander Lasse B.
Publisher: AMER PSYCHOLOGICAL ASSOC
Publication year: 2021
Journal: Psychological Bulletin
Journal name in source: PSYCHOLOGICAL BULLETIN
Journal acronym: PSYCHOL BULL
Volume: 147
Issue: 8
First page : 749
Last page: 786
Number of pages: 38
ISSN: 0033-2909
eISSN: 1939-1455
DOI: https://doi.org/10.1037/bul0000334(external)
Abstract
The high global prevalence of depression, together with the recent acceleration of remote care owing to the COVID-19 pandemic, has prompted increased interest in the efficacy of digital interventions for the treatment of depression. We provide a summary of the latest evidence base for digital interventions in the treatment of depression based on the largest study sample to date. A systematic literature search identified 83 studies (N = 15,530) that randomly allocated participants to a digital intervention for depression versus an active or inactive control condition. Overall heterogeneity was very high (I-2 = 84%). Using a random-effects multilevel metaregression model, we found a significant medium overall effect size of digital interventions compared with all control conditions (g = .52). Subgroup analyses revealed significant differences between interventions and different control conditions (WLC: g = .70; attention: g = .36; TAU: g = .31), significantly higher effect sizes in interventions that involved human therapeutic guidance (g = .63) compared with self-help interventions (g = .34), and significantly lower effect sizes for effectiveness trials (g = .30) compared with efficacy trials (g = .59). We found no significant difference in outcomes between smartphone-based apps and computer- and Internet-based interventions and no significant difference between human-guided digital interventions and face-to-face psychotherapy for depression, although the number of studies in both comparisons was low. Findings from the current meta-analysis provide evidence for the efficacy and effectiveness of digital interventions for the treatment of depression for a variety of populations. However, reported effect sizes may be exaggerated because of publication bias, and compliance with digital interventions outside of highly controlled settings remains a significant challenge.Public Significance Statement This meta-analysis demonstrates the efficacy of digital interventions in the treatment of depression for a variety of populations. Additionally, it highlights that digital interventions may have a valuable role to play in routine care, most notably when accompanied by human guidance. However, compliance with digital interventions remains a major challenge, with little more than 50% of participants completing the full intervention on average.
The high global prevalence of depression, together with the recent acceleration of remote care owing to the COVID-19 pandemic, has prompted increased interest in the efficacy of digital interventions for the treatment of depression. We provide a summary of the latest evidence base for digital interventions in the treatment of depression based on the largest study sample to date. A systematic literature search identified 83 studies (N = 15,530) that randomly allocated participants to a digital intervention for depression versus an active or inactive control condition. Overall heterogeneity was very high (I-2 = 84%). Using a random-effects multilevel metaregression model, we found a significant medium overall effect size of digital interventions compared with all control conditions (g = .52). Subgroup analyses revealed significant differences between interventions and different control conditions (WLC: g = .70; attention: g = .36; TAU: g = .31), significantly higher effect sizes in interventions that involved human therapeutic guidance (g = .63) compared with self-help interventions (g = .34), and significantly lower effect sizes for effectiveness trials (g = .30) compared with efficacy trials (g = .59). We found no significant difference in outcomes between smartphone-based apps and computer- and Internet-based interventions and no significant difference between human-guided digital interventions and face-to-face psychotherapy for depression, although the number of studies in both comparisons was low. Findings from the current meta-analysis provide evidence for the efficacy and effectiveness of digital interventions for the treatment of depression for a variety of populations. However, reported effect sizes may be exaggerated because of publication bias, and compliance with digital interventions outside of highly controlled settings remains a significant challenge.Public Significance Statement This meta-analysis demonstrates the efficacy of digital interventions in the treatment of depression for a variety of populations. Additionally, it highlights that digital interventions may have a valuable role to play in routine care, most notably when accompanied by human guidance. However, compliance with digital interventions remains a major challenge, with little more than 50% of participants completing the full intervention on average.
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