Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness

被引:76
作者
Pauley, Darin [1 ]
Cuijpers, Pim [1 ,2 ]
Papola, Davide [3 ]
Miguel, Clara [1 ]
Karyotaki, Eirini [1 ,2 ,4 ]
机构
[1] Vrije Univ, Amsterdam Publ Hlth Res Inst, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands
[2] WHO Collaborating Ctr Res & Disseminat Psychol In, Amsterdam, Netherlands
[3] Univ Verona, WHO Collaborating Ctr Res & Training Mental Hlth, Biomed & Movement Sci, Sect Psychiat,Dept Neurosci, Verona, Italy
[4] Harvard Med Sch, Dept Global Hlth & Social Med, Boston, MA USA
关键词
Anxiety disorders; digital interventions; effect size; effectiveness; meta-analysis; RANDOMIZED CONTROLLED-TRIAL; COGNITIVE-BEHAVIOR THERAPY; INTERNET-DELIVERED TREATMENT; SELF-HELP TREATMENT; PANIC DISORDER; SOCIAL PHOBIA; COMORBID DISORDERS; DEPRESSION; CARE; ACCEPTANCE;
D O I
10.1017/S0033291721001999
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68-0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: -0.01 to 0.30]. Conclusion The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.
引用
收藏
页码:567 / 579
页数:13
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