Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis
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 r...
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| creator | Ye, Xibiao Bapuji, Sunita Bayyavarapu Winters, Shannon Elizabeth Struthers, Ashley Raynard, Melissa Metge, Colleen Kreindler, Sara Adi Charette, Catherine Joan Lemaire, Jacqueline Angela Synyshyn, Margaret Sutherland, Karen |
| description | 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.
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 |
| doi_str_mv | 10.1186/1472-6963-14-313 |
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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.
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).
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.
PROSPERO registration: CRD42012002100.</description><identifier>ISSN: 1472-6963</identifier><identifier>EISSN: 1472-6963</identifier><identifier>DOI: 10.1186/1472-6963-14-313</identifier><identifier>PMID: 25037951</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Analysis ; Anxiety ; Anxiety Disorders - therapy ; Bias ; Bibliographic data bases ; Care and treatment ; Cellular telephones ; Child ; Child psychopathology ; Children & youth ; Clinical trials ; Data collection ; Data entry ; Depressive Disorder - therapy ; Estimates ; Health aspects ; Health sciences ; Health services ; Health Services Accessibility ; Humans ; Internet ; Intervention ; Mental depression ; Mental disorders ; Mental health ; Mental health care ; Meta-analysis ; Psychological aspects ; Psychotherapy - methods ; Quality ; Randomized Controlled Trials as Topic ; Ratings & rankings ; Remission (Medicine) ; Self help ; Social networks ; Telemedicine ; Young Adult ; Young adults</subject><ispartof>BMC health services research, 2014-07, Vol.14 (1), p.313-313, Article 313</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Ye et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Ye et al.; licensee BioMed Central Ltd. 2014 Ye et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b584t-fe40d070f0ad3d8285c4fad594bbad8d65cfc4465a3311ef31f24e9d32522a173</citedby><cites>FETCH-LOGICAL-b584t-fe40d070f0ad3d8285c4fad594bbad8d65cfc4465a3311ef31f24e9d32522a173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110069/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110069/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25037951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ye, Xibiao</creatorcontrib><creatorcontrib>Bapuji, Sunita Bayyavarapu</creatorcontrib><creatorcontrib>Winters, Shannon Elizabeth</creatorcontrib><creatorcontrib>Struthers, Ashley</creatorcontrib><creatorcontrib>Raynard, Melissa</creatorcontrib><creatorcontrib>Metge, Colleen</creatorcontrib><creatorcontrib>Kreindler, Sara Adi</creatorcontrib><creatorcontrib>Charette, Catherine Joan</creatorcontrib><creatorcontrib>Lemaire, Jacqueline Angela</creatorcontrib><creatorcontrib>Synyshyn, Margaret</creatorcontrib><creatorcontrib>Sutherland, Karen</creatorcontrib><title>Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis</title><title>BMC health services research</title><addtitle>BMC Health Serv Res</addtitle><description>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.
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.
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).
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.
PROSPERO registration: CRD42012002100.</description><subject>Adolescent</subject><subject>Analysis</subject><subject>Anxiety</subject><subject>Anxiety Disorders - therapy</subject><subject>Bias</subject><subject>Bibliographic data bases</subject><subject>Care and treatment</subject><subject>Cellular telephones</subject><subject>Child</subject><subject>Child psychopathology</subject><subject>Children & youth</subject><subject>Clinical trials</subject><subject>Data collection</subject><subject>Data entry</subject><subject>Depressive Disorder - therapy</subject><subject>Estimates</subject><subject>Health aspects</subject><subject>Health sciences</subject><subject>Health services</subject><subject>Health Services Accessibility</subject><subject>Humans</subject><subject>Internet</subject><subject>Intervention</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mental health care</subject><subject>Meta-analysis</subject><subject>Psychological aspects</subject><subject>Psychotherapy - methods</subject><subject>Quality</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Ratings & rankings</subject><subject>Remission (Medicine)</subject><subject>Self help</subject><subject>Social networks</subject><subject>Telemedicine</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1472-6963</issn><issn>1472-6963</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFUs1vFCEUnxiNrdW7J0PixUOnhQHmw4NJs6nVpIkXPRMGHrs0M7ACs3X_FP9bGbddu6bGcODxfh883qMoXhN8RkhbnxPWVGXd1bQkrKSEPimO96mnD-Kj4kWMNxiTpq2a58VRxTFtOk6Oi5-XxoBKdgMOYkTeIOsSBAep7GUEvTtmNFnvIjI-ILWygw7gTtHWT2l1iqTTc-iWSOppSBHd2rTK2R8W0nZGz7NKwzrkG7LLeyRR3MYEo0xWoQAbC7e_TUZIspRODtto48vimZFDhFd3-0nx7ePl18Wn8vrL1efFxXXZ85al0gDDGjfYYKmpbquWK2ak5h3re6lbXXNlFGM1l5QSAoYSUzHoNK14VUnS0JPiw853PfUjaJWfGuQg1sGOMmyFl1YcIs6uxNJvBCME47rLBoudQW_9PwwOEeVHMY9GzKPJkciTyy7v7soI_vsEMYnRRgXDIB34KQrCOetY02Tu_6msrWnbNHNtb_-i3vgp5A7vWLRu6679w1rKAYR1xuc61WwqLjjteNfVDcuss0dYeWkYrfIOjM35AwHeCVTwMQYw-54QLOb_-1gX3jwcxl5w_2HpLx9D7eU</recordid><startdate>20140718</startdate><enddate>20140718</enddate><creator>Ye, Xibiao</creator><creator>Bapuji, Sunita Bayyavarapu</creator><creator>Winters, Shannon Elizabeth</creator><creator>Struthers, Ashley</creator><creator>Raynard, Melissa</creator><creator>Metge, Colleen</creator><creator>Kreindler, Sara Adi</creator><creator>Charette, Catherine Joan</creator><creator>Lemaire, Jacqueline Angela</creator><creator>Synyshyn, Margaret</creator><creator>Sutherland, Karen</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>KB0</scope><scope>L.-</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20140718</creationdate><title>Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis</title><author>Ye, Xibiao ; Bapuji, Sunita Bayyavarapu ; Winters, Shannon Elizabeth ; Struthers, Ashley ; Raynard, Melissa ; Metge, Colleen ; Kreindler, Sara Adi ; Charette, Catherine Joan ; Lemaire, Jacqueline Angela ; Synyshyn, Margaret ; Sutherland, Karen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b584t-fe40d070f0ad3d8285c4fad594bbad8d65cfc4465a3311ef31f24e9d32522a173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Analysis</topic><topic>Anxiety</topic><topic>Anxiety Disorders - 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Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ye, Xibiao</au><au>Bapuji, Sunita Bayyavarapu</au><au>Winters, Shannon Elizabeth</au><au>Struthers, Ashley</au><au>Raynard, Melissa</au><au>Metge, Colleen</au><au>Kreindler, Sara Adi</au><au>Charette, Catherine Joan</au><au>Lemaire, Jacqueline Angela</au><au>Synyshyn, Margaret</au><au>Sutherland, Karen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis</atitle><jtitle>BMC health services research</jtitle><addtitle>BMC Health Serv Res</addtitle><date>2014-07-18</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>313</spage><epage>313</epage><pages>313-313</pages><artnum>313</artnum><issn>1472-6963</issn><eissn>1472-6963</eissn><abstract>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.
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.
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).
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.
PROSPERO registration: CRD42012002100.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25037951</pmid><doi>10.1186/1472-6963-14-313</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings; PubMed Central Open Access; Springer Nature OA Free Journals |
| subjects | Adolescent Analysis Anxiety Anxiety Disorders - therapy Bias Bibliographic data bases Care and treatment Cellular telephones Child Child psychopathology Children & youth Clinical trials Data collection Data entry Depressive Disorder - therapy Estimates Health aspects Health sciences Health services Health Services Accessibility Humans Internet Intervention Mental depression Mental disorders Mental health Mental health care Meta-analysis Psychological aspects Psychotherapy - methods Quality Randomized Controlled Trials as Topic Ratings & rankings Remission (Medicine) Self help Social networks Telemedicine Young Adult Young adults |
| title | Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis |
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