TY - JOUR
T1 - Digital Interventions for the Treatment of Depression
T2 - A Meta-Analytic Review
AU - Moshe, Isaac
AU - Terhorst, Yannik
AU - Philippi, Paula
AU - Domhardt, Matthias
AU - Cuijpers, Pim
AU - Cristea, Ioana
AU - Pulkki-Råback, Laura
AU - Baumeister, Harald
AU - Sander, Lasse B.
N1 - Publisher Copyright:
© 2021. American Psychological Association
PY - 2021/8
Y1 - 2021/8
N2 - 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 (I2 = 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.
AB - 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 (I2 = 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.
KW - Depression
KW - Internet-based interventions
KW - Meta-analysis
KW - Review
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U2 - 10.1037/bul0000334
DO - 10.1037/bul0000334
M3 - Article
C2 - 34898233
AN - SCOPUS:85122773923
SN - 0033-2909
VL - 147
SP - 749
EP - 786
JO - Psychological Bulletin
JF - Psychological Bulletin
IS - 8
ER -