The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data

被引：0

作者：

Sander, Lasse B. ^{[1
]}

Beisemann, Marie ^{[2
]}

Doebler, Philipp ^{[2
]}

Micklitz, Hannah Moon ^{[1
]}

Kerkhof, Ad ^{[3
]}

Cuijpers, Pim ^{[3
]}

Batterham, Philip ^{[4
]}

Calear, Alison ^{[4
]}

Christensen, Helen ^{[5
,6
]}

De Jaegere, Eva ^{[7
]}

Domhardt, Matthias ^{[8
]}

Erlangsen, Annette ^{[9
]}

Bergeijk, Ozlem Eylem-van ^{[10
]}

Hill, Ryan ^{[11
]}

Muhlmann, Charlotte ^{[9
]}

Oesterle, Marie ^{[1
]}

Pettit, Jeremy ^{[12
]}

Portzky, Gwendolyn ^{[7
]}

Steubl, Lena ^{[8
]}

van Spijker, Bregje ^{[4
]}

Tighe, Joseph ^{[5
]}

Werner-Seidler, Aliza ^{[5
]}

Buescher, Rebekka ^{[1
]}

机构：

[1] Univ Freiburg, Fac Med, Med Psychol & Med Sociol, Hebelstr 29, D-79104 Freiburg, Germany

[2] Tech Univ Dortmund, Dept Stat, Dortmund, Germany

[3] Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands

[4] Australian Natl Univ, Coll Hlth & Med, Ctr Mental Hlth Res, Canberra, ACT, Australia

[5] Univ New South Wales, Black Dog Inst, Sydney, NSW, Australia

[6] Univ New South Wales, Sch Med, Sydney, NSW, Australia

[7] Univ Ghent, Flemish Ctr Expertise Suicide Prevent, Dept Head & Skin, Ghent, Belgium

[8] Ulm Univ, Dept Clin Psychol & Psychotherapy, Ulm, Germany

[9] Mental Hlth Ctr Copenhagen, Danish Res Inst Suicide Prevent, Copenhagen, Denmark

[10] Webster Univ Leiden, Fac Behav & Social Sci, Leiden, Netherlands

[11] Louisiana State Univ, Dept Psychol, Baton Rouge, LA USA

[12] Florida Int Univ, Ctr Children & Families, Dept Psychol, Miami, FL USA

来源：

JOURNAL OF MEDICAL INTERNET RESEARCH | 2023年 / 25卷

关键词：

meta-analysis; internet-based cognitive behavioral therapy; suicidal ideation; anxiety; depression; hopelessness; depressive; mental health; systematic review; review method; suicide; suicidal; psychotherapy; CBT; cognitive behavioral therapy; RANDOMIZED CONTROLLED-TRIAL; DELIVERED TREATMENT; COMORBID DISORDERS; RISK-FACTORS; INTERVENTIONS; THOUGHTS;

D O I：

10.2023/1/e46771

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Suicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors. Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. However, suicidal ideation often is related to additional mental health problems, which should be addressed for optimal care. Yet, the effects of iCBT on related symptoms, such as depression, anxiety, and hopelessness, remain unclear. Objective: We aimed to analyze whether digital interventions targeting suicidal ideation had an effect on related mental health symptoms (depression, anxiety, and hopelessness). Methods: We systematically searched CENTRAL, PsycInfo, Embase, and PubMed for randomized controlled trials that investigated guided or unguided iCBT for suicidal ideation or behaviors. Participants reporting baseline suicidal ideation were eligible. Individual participant data (IPD) were collected from eligible trials. We conducted a 1-stage IPD meta-analysis on the effects on depression, anxiety, and hopelessness-analyzed as 2 indices: symptom severity and treatment response. Results: We included IPD from 8 out of 9 eligible trials comprising 1980 participants with suicidal ideation. iCBT was associated with significant reductions in depression severity (b=-0.17; 95% CI -0.25 to -0.09; P<.001) and higher treatment response (ie, 50% reduction of depressive symptoms; b=0.36; 95% CI 0.12-0.60; P=.008) after treatment. We did not find significant effects on anxiety and hopelessness. Conclusions: iCBT for people with suicidal ideation revealed significant effects on depression outcomes but only minor or no effects on anxiety and hopelessness. Therefore, individuals with comorbid symptoms of anxiety or hopelessness may require additional treatment components to optimize care. Studies that monitor symptoms with higher temporal resolution and consider a broader spectrum of factors influencing suicidal ideation are needed to understand the complex interaction of suicidality and related mental health symptoms.

引用

页数：15