Internet-based cognitive behavioral therapy may reduce depression in adolescents Original paper

In this meta-analysis of randomized controlled trials, internet-based cognitive behavioral therapy reduced depression and anxiety among adolescents, with very low certainty of evidence.

This Study Summary was published on February 9, 2024.

Quick Summary

In this meta-analysis of randomized controlled trials, internet-based cognitive behavioral therapy reduced depression and anxiety among adolescents, with very low certainty of evidence.

What was studied?

The efficacy of internet-based cognitive behavioral therapy (iCBT) among adolescents with depression.

Depression, anxiety, and quality of life were assessed using validated scales completed by participants, clinicians, and/or parents.

Who was studied?

1,683 adolescents (age 10–19) with depression, as determined by physician diagnosis or validated scale.

Most of the studies were conducted in high-income countries (based on World Bank criteria) such as Sweden, New Zealand, and the United Kingdom.

How was it studied?

This meta-analysis included data from 18 randomized controlled trials (RCTs). All of the trials included control conditions, such as being waitlisted, receiving standard treatment without CBT, or receiving “attention control” interventions such as general health education.

The iCBT interventions included chatbots, self-directed online games such as SPARX, as well as therapist-guided programs delivered in primary care settings.

What were the results?

Depression was reduced by iCBT interventions in comparison with control conditions, but the certainty of evidence was very low. A reduction in depression was observed on self-reported, clinician-reported, and parent-reported scales.

Anxiety was also reduced with iCBT in comparison with control conditions, but no improvements in quality of life were observed (based on 5 trials).

Anything else I need to know?

Some caution is appropriate when interpreting these findings, due to heterogeneity and risk of bias (4 out of 18 studies were graded as having a high risk of bias, and 6 were graded as having some concerns of bias).

This Study Summary was published on February 9, 2024.