The following is a summary of “Efficacy of computer- and/or internet-based cognitive-behavioral guided self-management for depression in adults: a systematic review and meta-analysis of randomized controlled trials” published in the November 2022 issue of Psychiatry by Mamukashvili-Delau et al.


Sadness affects people all across the world. Patients with mild to severe depressive symptoms can benefit from Cognitive behavioral therapy (CBT)-based self-help treatment or use it to get through the waiting or epidemic time before they can access clinical care. This meta-analysis and systematic review aimed to examine the usefulness, acceptability, and quality of life enhancement of CBT self-help therapies for depression that are provided through computers and the internet and require just brief periods of coaching (up to 10 minutes). The secondary objective was to evaluate the relative efficacy of 4 different forms of minimal advice for reducing post-treatment depression symptoms: e-mail, phone calls, a combination of e-mail and phone calls, and in-person meetings.

Published and unpublished Randomized controlled trials (RCTs) reporting the efficacy of computer- and internet-based CBT self-help treatments for depression with minimal guidance of up to 10 minutes per week were sought using the Cochrane depression, anxiety, and neurosis review group’s specialized register electronic searches, grey literature, reference lists, and correspondence. Using the Cochrane Collaboration’s instruments for gauging the likelihood of bias, researchers assessed the included studies’ adherence to the study protocols. The RevMen program was used to complete the meta-analysis. In all, 2809 abstracts from studies were evaluated for inclusion. A total of 3,226 people from 19 research (21 samples) were considered for inclusion. The effect size of 0.65 indicates that the treatment group is significantly more effective than the control group. Further, compared to those receiving minimal instruction, those receiving mixed e-mail and phone conversations had the greatest benefits (Standardized Mean Difference (SMD) -0.76). (guided by e-mail SMD -0.63; guided face-to-face SMD – 0.66; guided by telephone calls SMD -0.49). Results also demonstrated that iCBT with minimal coaching improved quality of life, albeit marginally (effect size =0.28) but statistically significantly. The treatment condition also had a higher rate of attrition than the control groups (risk ratio (RR)= 1.36).

This meta-analysis shows that internet- and computer-based CBT self-help programs effectively reduce post-treatment depression symptoms for adults, even when providing as little as 10 minutes of advice per week. The findings also suggest 2 potential applications. In the first place, people with depression can utilize self-help treatment with limited assistance at home to alleviate their symptoms or to get them through the waiting time or interim period until they can get in-person care from a trained expert. Second, it can aid doctors in deciding whether or not to combine CBT-based self-help treatments with in-person therapy for patients who do not require immediate professional care.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-04325-z