Effects of Digital Psychotherapy on Suicide: A Systematic Review and Meta-Analysis

Previous studies reported that digital psychotherapy was a clinically beneficial intervention for suicide ideation. However, the effects of digital psychotherapy on other aspects of suicide beyond ideation remain unclear. Therefore, this study investigated the effects of digital psychotherapy on suicide and depression. Articles were identified by searching Cochrane, Google Scholar, Medline, PubMed, Web of Science, and PsycINFO in line with the PRISMA statement, yielding nine randomized controlled trials. The difference between conditions regarding suicide and depression in the effect size of the individual article was calculated using Hedges' g. Most digital psychotherapy interventions were based on cognitive behavioral therapy and delivered via apps or the web for at least six weeks. Suicide outcomes primarily focused on suicide ideation. The findings showed digital psychotherapy achieved a significantly larger effect size for suicide (g = 0.488, p < 0.001) and depression (g = 0.316, p < 0.001), compared to controls. Specifically, digital psychotherapy showed a significant effect on both suicide ideation (g = 0.478, p < 0.001) and other suicidal variables (g = 0.330, p < 0.001). These results suggest the effectiveness of digital psychotherapy in reducing suicide and depression compared to traditional face-to-face therapy. Future research should consider a wider range of outcomes and examine the long-term effectiveness of digital psychotherapy to better understand its effects on suicide prevention.