Evidence map›Paper›PMID 25786025›Full record

SynthesisPloS one2015

Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials.

David Daniel Ebert, Anna-Carlotta Zarski, Helen Christensen, Yvonne Stikkelbroek, Pim Cuijpers, Matthias Berking, Heleen Riper

Registry-linked trialAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03903978 (Efficacy and Effectiveness of a Self-applied Online Program to Promote Resilience and Coping Skills in University Students in Three Spanish-speaking Countries), which is not on this map. Cited by 253 papers, 24 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
253citing papers in PubMed, 24 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03903978 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Efficacy and Effectiveness of a Self-applied Online Program to Promote Resilience and Coping Skills in University Students in Three Spanish-speaking Countries: Study Protocol for a Randomized Controlled Trial

TypeinterventionalSponsorUniversitat Jaume IRan2018 to 2020Enrolled324ConditionsCORE Condition, Healthy Lifestyle Psychoeducational Program, Waiting List ControlArmsCognitive Behavioral Therapy, Healthy lifestyle
3 · Its place in the literature

Who cites it

253 citing papers in PubMed, 24 syntheses or guidelines pooled it.

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193 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

David Daniel EbertLeuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany; Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany; Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands.
Anna-Carlotta ZarskiLeuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany.
Helen ChristensenBlack Dog Institute, Sydney, Australia.
Yvonne StikkelbroekCenter for Child and Adolescent Studies, University of Utrecht, the Netherlands.
Pim CuijpersLeuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany; GGZ inGeest, Regional Mental Health Service Centre, VU University Medical Centre, Amsterdam, the Netherlands; Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands.
Matthias BerkingLeuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany; Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany.
Heleen RiperLeuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany; GGZ inGeest, Regional Mental Health Service Centre, VU University Medical Centre, Amsterdam, the Netherlands; Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnxiety and depression in children and adolescents are undertreated. Computer- and Internet-based cognitive behavioral treatments (cCBT) may be an attractive treatment alternative to regular face-to-face treatment.This meta-analysis aims to evaluate whether cCBT is effective for treating symptoms of anxiety and depression in youth. METHODS AND

findingsWe conducted systematic searches in bibliographical databases (Pubmed, Cochrane controlled trial register, PsychInfo) up to December 4, 2013. Only randomized controlled trials in which a computer-, Internet- or mobile-based cognitive behavioral intervention targeting either depression, anxiety or both in children or adolescents up to the age of 25 were compared to a control condition were selected. We employed a random-effects pooling model in overall effect analyses and a mixed effect model for sub-group analyses. Searches resulted in identifying 13 randomized trials, including 796 children and adolescents that met inclusion criteria. Seven studies were directed at treating anxiety, four studies at depression, and two were of a transdiagnostic nature, targeting both anxiety and depression. The overall mean effect size (Hedges' g) of cCBT on symptoms of anxiety or depression at post-test was g=0.72 (95% CI:0.55-0.90, numbers needed to be treated (NNT)=2.56). Heterogeneity was low (I²=20.14%, 95% CI: 0-58%). The superiority of cCBT over controls was evident for interventions targeting anxiety (g=0.68; 95% CI: 0.45-0.92; p < .001; NNT=2.70) and for interventions targeting depression (g=0.76; 95% CI: 0.41-0.12; p < .001; NNT=2.44) as well as for transdiagnostic interventions (g=0.94; 95% CI: 0.23-2.66; p < .001; NNT=2.60).

conclusionsResults provide evidence for the efficacy of cCBT in the treatment of anxiety and depressive symptoms in youth. Hence, such interventions may be a promising treatment alternative when evidence based face-to-face treatment is not feasible. Future studies should examine long-term effects of treatments and should focus on obtaining patient-level data from existing studies, to perform an individual patient data meta-analysis.

Indexed as

InternetAdolescentAnxietyChildCognitive Behavioral TherapyDepressionHumansModels, StatisticalRandomized Controlled Trials as TopicTherapy, Computer-AssistedYoung Adult

Identifiers

PMID25786025
PMCPMC4364968

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.