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Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis

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  • Gavin Andrews
  • Pim Cuijpers
  • Michelle G Craske
  • Peter McEvoy
  • Nickolai Titov

Abstract

Background: Depression and anxiety disorders are common and treatable with cognitive behavior therapy (CBT), but access to this therapy is limited. Objective: Review evidence that computerized CBT for the anxiety and depressive disorders is acceptable to patients and effective in the short and longer term. Method: Systematic reviews and data bases were searched for randomized controlled trials of computerized cognitive behavior therapy versus a treatment or control condition in people who met diagnostic criteria for major depression, panic disorder, social phobia or generalized anxiety disorder. Number randomized, superiority of treatment versus control (Hedges g) on primary outcome measure, risk of bias, length of follow up, patient adherence and satisfaction were extracted. Principal Findings: 22 studies of comparisons with a control group were identified. The mean effect size superiority was 0.88 (NNT 2.13), and the benefit was evident across all four disorders. Improvement from computerized CBT was maintained for a median of 26 weeks follow-up. Acceptability, as indicated by adherence and satisfaction, was good. Research probity was good and bias risk low. Effect sizes were non-significantly higher in comparisons with waitlist than with active treatment control conditions. Five studies comparing computerized CBT with traditional face-to-face CBT were identified, and both modes of treatment appeared equally beneficial. Conclusions: Computerized CBT for anxiety and depressive disorders, especially via the internet, has the capacity to provide effective acceptable and practical health care for those who might otherwise remain untreated. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12610000030077

Suggested Citation

  • Gavin Andrews & Pim Cuijpers & Michelle G Craske & Peter McEvoy & Nickolai Titov, 2010. "Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-6, October.
    • Handle: RePEc:plo:pone00:0013196
    DOI: 10.1371/journal.pone.0013196
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    1. Kotaro Imamura & Norito Kawakami & Toshi A Furukawa & Yutaka Matsuyama & Akihito Shimazu & Rino Umanodan & Sonoko Kawakami & Kiyoto Kasai, 2014. "Effects of an Internet-Based Cognitive Behavioral Therapy (iCBT) Program in Manga Format on Improving Subthreshold Depressive Symptoms among Healthy Workers: A Randomized Controlled Trial," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-13, May.
    2. Alba Quilez-Orden & Vanesa Ferreres-Galán & Jorge Osma, 2020. "Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design," IJERPH, MDPI, vol. 17(17), pages 1-18, August.
    3. Sanne P. A. Rasing & Yvonne A. J. Stikkelbroek & Wouter den Hollander & Ana Okorn & Denise H. M. Bodden, 2021. "Long Term Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders: Analyses at 12 Months Post-Treatment," Social Sciences, MDPI, vol. 10(10), pages 1-13, October.
    4. Sanne P.A. Rasing & Yvonne A.J. Stikkelbroek & Wouter den Hollander & Heleen Riper & Maja Deković & Maaike H. Nauta & Daan H.M. Creemers & Marianne C.P. Immink & Mariken Spuij & Denise H.M. Bodden, 2021. "Pragmatic Quasi-Experimental Controlled Trial Evaluating the Outcomes of Blended CBT Compared to Face-to-Face CBT and Treatment as Usual for Adolescents with Depressive Disorders," IJERPH, MDPI, vol. 18(6), pages 1-17, March.
    5. David Daniel Ebert & Anna-Carlotta Zarski & Helen Christensen & Yvonne Stikkelbroek & Pim Cuijpers & Matthias Berking & Heleen Riper, 2015. "Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Youth: A Meta-Analysis of Randomized Controlled Outcome Trials," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    6. Toshi A Furukawa & Masaru Horikoshi & Norito Kawakami & Masayo Kadota & Megumi Sasaki & Yuki Sekiya & Hiroki Hosogoshi & Masami Kashimura & Kenichi Asano & Hitomi Terashima & Kazunori Iwasa & Minoru N, 2012. "Telephone Cognitive-Behavioral Therapy for Subthreshold Depression and Presenteeism in Workplace: A Randomized Controlled Trial," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-9, April.
    7. Kai Sing Sun & Tai Pong Lam & Dan Wu, 2018. "Chinese perspectives on primary care for common mental disorders: Barriers and policy implications," International Journal of Social Psychiatry, , vol. 64(5), pages 417-426, August.
    8. Rüdiger Zwerenz & Jan Becker & Katharina Gerzymisch & Martin Siepmann & Martin Holme & Ulrich Kiwus & Sieglinde Spörl-Dönch & Manfred E Beutel, 2017. "Evaluation of a transdiagnostic psychodynamic online intervention to support return to work: A randomized controlled trial," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-17, May.
    9. Elizabeth Stratton & Amit Lampit & Isabella Choi & Rafael A Calvo & Samuel B Harvey & Nicholas Glozier, 2017. "Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-23, December.
    10. Nicole Andrejek & Sabrina Hossain & Nour Schoueri-Mychasiw & Gul Saeed & Maral Zibaman & Angie K. Puerto Niño & Samantha Meltzer-Brody & Richard K. Silver & Simone N. Vigod & Daisy R. Singla, 2021. "Barriers and Facilitators to Resuming In-Person Psychotherapy with Perinatal Patients amid the COVID-19 Pandemic: A Multistakeholder Perspective," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    11. Sunah Kim & Go-Un Kim & Wongyeong Lee & Jinyoung Park, 2021. "Developing an Internet-Based Trauma Recovery Nursing Intervention Based on Swanson’s Theory of Caring for Trauma Recovery," IJERPH, MDPI, vol. 18(13), pages 1-13, June.
    12. Nerea Almeda & Carlos R. García-Alonso & José A. Salinas-Pérez & Mencía R. Gutiérrez-Colosía & Luis Salvador-Carulla, 2019. "Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review," IJERPH, MDPI, vol. 16(3), pages 1-20, January.
    13. David R. Cregg & Jennifer S. Cheavens, 2021. "Gratitude Interventions: Effective Self-help? A Meta-analysis of the Impact on Symptoms of Depression and Anxiety," Journal of Happiness Studies, Springer, vol. 22(1), pages 413-445, January.
    14. Wouter Smink & Anneke M Sools & Janneke M van der Zwaan & Sytske Wiegersma & Bernard P Veldkamp & Gerben J Westerhof, 2019. "Towards text mining therapeutic change: A systematic review of text-based methods for Therapeutic Change Process Research," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-21, December.
    15. Margrit Löbner & Janine Stein & Melanie Luppa & Markus Bleckwenn & Anja Mehnert-Theuerkauf & Steffi G. Riedel-Heller, 2022. "What Comes after the Trial? An Observational Study of the Real-World Uptake of an E-Mental Health Intervention by General Practitioners to Reduce Depressive Symptoms in Their Patients," IJERPH, MDPI, vol. 19(10), pages 1-12, May.
    16. Shelley L. Craig & Vivian W. Y. Leung & Rachael Pascoe & Nelson Pang & Gio Iacono & Ashley Austin & Frank Dillon, 2021. "AFFIRM Online: Utilising an Affirmative Cognitive–Behavioural Digital Intervention to Improve Mental Health, Access, and Engagement among LGBTQA+ Youth and Young Adults," IJERPH, MDPI, vol. 18(4), pages 1-17, February.

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