Cognitive behavioural therapy versus other interventions on mental health in people with sensory impairments: A systematic review and meta-analysis

Background: Sensory impairments can negatively affect people's quality of life and daily functioning, including anxiety and depression symptoms. Cognitive behavioural therapy (CBT) could be an effective intervention to alleviate these, however its effectiveness compared to other interventions have not been examined. The aim of this review was to examine the effectiveness of CBT versus other interventions on anxiety and depression symptoms in people with hearing, visual, and other sensory impairments. Methods: This systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted using a pre-registered protocol (Prospero ID:CRD42023425953). Searches were conducted in across six databases from inception through October 2024. Random-effects meta-analyses were performed. Results: Of 18 included studies, interventions for tinnitus yielded a significant effect favouring intervention on anxiety (Hedge's g = 0.5;95 %CI0.3-0.9) and depression symptoms (Hedge's g = 0.4; 95 %CI 0.1-0.6). Interventions for people with hearing loss not related to tinnitus yielded a significant effect favouring intervention on anxiety symptoms (Hedge's g = 0.6;95 %CI 0.2-1.1), but not in depression symptoms (Hedge's g = 0.3;95 %CI-0.0;0.6). When sub-grouped, no significant differences between CBT and other interventions were found. Interventions for people with vision impairment yielded a non-significant difference in depression symptoms (Hedge's g = 0.4;95 %CI-0.0;0.7), with no studies found examining anxiety symptoms. Conclusion: No significant differences were found when comparing CBT versus other interventions in hearing loss. The effectiveness of CBT for people with visual impairment was less clear due to a small number of studies. Future studies should consider other types of sensory impairments.