Evidence map›Paper›PMID 33471111›Full record

SynthesisJAMA psychiatry2021

Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis.

Eirini Karyotaki, Orestis Efthimiou, Clara Miguel, Frederic Maas Genannt Bermpohl, Toshi A Furukawa, Pim Cuijpers, Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration, Heleen Riper, Vikram Patel, Adriana Mira and 64 more

Erratum issued 8 registry-linked trialsAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 8 registered trials, which are not on this map. Cited by 477 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
477citing papers in PubMed, 19 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.

NCT05746767 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation

SUPERA: Supporting Peer Interactions to Expand Access to Digital Cognitive Behavioral Therapy for Spanish-speaking Safety-Net Patients in Primary Care

TypeinterventionalSponsorUniversity of California, IrvineRan2024 to 2028Enrolled426ConditionsDepression, AnxietyArmsSupported dCBT, Unsupported dCBT
NCT06418997 nacompletednot on this mapstarted 2024, after this paper: background citation

Cognitive Behavioral Immersion: A Randomized Control Trial of Peer-Based Coaching in the Metaverse

TypeinterventionalSponsorUniversity of Southern CaliforniaRan2024 to 2025Enrolled306ConditionsDepression, AnxietyArmsCBI
NCT06480474 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Internet-based Treatment for Depression: a Randomized Controlled Trial Comparing Therapist Support and Peer-support Using an Online Forum.

TypeinterventionalSponsorUniversity of FribourgRan2024 to 2026Enrolled240ConditionsDepressionArmsDeprexis, Deprexis with online forum
NCT06658756 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Implementation of Internet-Based Psychotherapy for Obsessive-Compulsive Disorder (OCD) in Primary Health Care in Two Cities in the State of São Paulo

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2025 to 2028Enrolled140ConditionsObsessive-Compulsive DisorderArmsinternet-CBT
NCT07113548 narecruitingnot on this mapstarted 2025, after this paper: background citation

PERSONAE: a Personalized Adaptation of Stepped Care Internet-based Cognitive Behavioral Therapy for Depression - A Randomized Controlled Trial

TypeinterventionalSponsorRegion of Southern DenmarkRan2025 to 2027Enrolled175ConditionsDepression - Major Depressive DisorderArmsPersonalized iCBT for depression, Standard iCBT
NCT07140497 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Reduction of Anxiety Through Dual Mental Health Treatment: Digital-Based Cognitive Behavioral Therapy (CBT) and National Board for Health and Wellness Coaching (NBHWC) Mental Health Coaches for People With Disabilities (RADD)

TypeinterventionalSponsorToivoa IncRan2026 to 2027Enrolled200ConditionsHearing Disability, Anxiety, Mobility DisabilityArmsSham Digital Program - General health education and interactive quizzes unrelated to anxiety or CBT., Toivoa-001 - A digital Cognitive Behavioral Therapy program combined with NBHWC-certified coaching.
NCT07195292 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Reduction of Depression Through Dual Mental Health Treatment: Digital-Based Cognitive Behavioral Therapy (CBT) and National Board for Health and Wellness Coaching (NBHWC) Mental Health Coaches for People With Disabilities (ReDu)

TypeinterventionalSponsorToivoa IncRan2026 to 2027Enrolled200ConditionsHearing Disability, Depression, Mobility DisabilityArmsSham Digital Program - General health education and interactive quizzes unrelated to depression or CBT., Toivoa-002 - A digital Cognitive Behavioral Therapy program combined with NBHWC-certified coaching.
NCT07532551 narecruitingnot on this mapstarted 2026, after this paper: background citation

Assessing the Clinical and Cost Effectiveness of Internet-Based Cognitive Behavioural Therapy (iCBT) for Anxiety and Depression in Singapore

TypeinterventionalSponsorNational University of SingaporeRan2026 to 2028Enrolled390ConditionsDepression and/or Anxiety in the Mild-to-moderate Range, Cognitive Behavioral TherapyArmsInternet-delivered cognitive behavioural therapy (iCBT)
3 · Its place in the literature

Who cites it

477 citing papers in PubMed, 19 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

74 authors.

Eirini KaryotakiInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Orestis EfthimiouInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Clara MiguelDepartment of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Frederic Maas Genannt BermpohlDepartment of Clinical Psychology and Psychotherapy, University of Wuppertal, Wuppertal, Germany.
Toshi A FurukawaDepartment of Clinical Psychology and Psychotherapy, University of Wuppertal, Wuppertal, Germany.
Pim CuijpersDepartment of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration
Heleen RiperDepartment of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Vikram PatelDepartment of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts.
Adriana MiraPROMOSAM Excellence in Research Program, MINECO, Valencia, Spain.
Alan W GemmilParent-Infant Research Institute, Department of Clinical and Health Psychology, Heidelberg Repatriation Hospital, Austin Health, Ivanhoe, Victoria, Australia.
Albert S YeungDepression Clinical and Research Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
Alfred LangeDepartment of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands.
Alishia D WilliamsDepartment of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Andrew MackinnonPrince of Wales Hospital, Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.
Anna GeraedtsHumanTotalCare, Utrecht, the Netherlands.
Annemieke van StratenDepartment of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Björn MeyerResearch Department, Gaia AG, Hamburg, Germany.
Cecilia BjörkelundPrimary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg School of Public Health and Community Medicine, Gothenburg, Sweden.
Christine KnaevelsrudDepartment for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany.
Christopher G BeeversDepartment of Psychology and Institute for Mental Health Research, The University of Texas at Austin.
Cristina BotellaDepartment of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellon, Spain.
Daniel R StrunkDepartment of Psychology, The Ohio State University, Columbus, Ohio.
David C MohrCenter for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
David D EbertDepartment of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
David KesslerCentre for Academic Primary Care, Bristol Medical School (Population Health Sciences), University of Bristol, Bristol, England.
Derek RichardsE-mental Health Research Group, Trinity College Dublin School of Psychology, Dublin, Ireland.
Elizabeth LittlewoodDepartment of Health Sciences, University of York, York, England.
Erik ForsellCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Fan FengBenson Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
Fang WangDepartment of Psychology and Sleep Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Gerhard AnderssonCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Heather HadjistavropoulosDepartment of Psychology, University of Regina, Regina, Saskatchewan, Canada.
Heleen ChristensenPrince of Wales Hospital, Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.
Iony D EzawaDepartment of Psychology, The Ohio State University, Columbus, Ohio.
Isabella ChoiCentral Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Isabelle M RossoMcLean Hospital, Belmont, Massachusetts.
Jan Philipp KleinDepartment of Psychiatry and Psychotherapy, Luebeck University, Luebeck, Germany.
Jason ShumakeDepartment of Psychology and Institute for Mental Health Research, The University of Texas at Austin.
Javier Garcia-CampayoAragon Institute for Health Research (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain.
Jeannette MilgromParent-Infant Research Institute, Department of Clinical and Health Psychology, Heidelberg Repatriation Hospital, Austin Health, Ivanhoe, Victoria, Australia.
Jessica SmithImperial Clinical Trials Unit, Imperial College London, London, England.
Jesus Montero-MarinWarneford Hospital, Department of Psychiatry, University of Oxford, Oxford, England.
Jill M NewbyDepartment of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Juana Bretón-LópezDepartment of Basic Psychology, Clinic and Psychobiology, Jaume I University, Castellon, Spain.
Justine SchneiderInstitute of Mental Health, University of Nottingham, Nottingham, England.
Kristofer VernmarkDepartment of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
Lara BückerDepartment of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Lisa B SheeberOregon Research Institute, Eugene, Oregon.
Lisanne WarmerdamNational Health Care Institute, Diemen, the Netherlands.
Louise FarrerCentre for Mental Health Research, The Australian National University, Canberra, Australia.
Manuel HeinrichDepartment for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany.
Marcus J H HuibersDepartment of Clinical Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Marie KiviDepartment of Psychology and AgeCap, University of Gothenburg, Gothenburg, Sweden.
Martin KraepelienCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Nicholas R ForandDepartment of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Nicky PughDepartment of Psychology, University of Regina, Regina, Saskatchewan, Canada.
Nils LindeforsCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Ove LintvedtNorwegian Center for E-health research, Tromsø, Norway.
Pavle ZagorscakDepartment for Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany.
Per CarlbringDepartment of Psychology, Stockholm University, Stockholm, Sweden.
Rachel PhillipsFaculty of Medicine, Imperial College London School of Public Health, London, England.
Robert JohanssonDepartment of Psychology, Stockholm University, Stockholm, Sweden.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Sally BrabynClinical Research & Innovation, SilverCloud Health, Dublin, Ireland.
Sarah PeriniThe Clinical Psychology Centre, Sydney, New South Wales, Australia.
Scott L RauchMcLean Hospital, Belmont, Massachusetts.
Simon GilbodyDepartment of Health Sciences, University of York, York, England.
Steffen MoritzDepartment of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Thomas BergerDepartment of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
Victor PopDepartment of Clinical and Medical Health Psychology, Tilburg University, Tilburg, the Netherlands.
Viktor KaldoCentre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Viola SpekDepartment of Clinical and Medical Health Psychology, Tilburg University, Tilburg, the Netherlands.
Yvonne ForsellSection of Epidemiology and Public Health Intervention Research, Department of Global Public Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden.

Funding

Technology Enabled Services for Coordinated Care of Depression in Healthcare SettingsP50MH119029 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI DAVID CURTIS MOHR, Jessica Lee Schleider · 2020 to 2026
$10.7M
NIMH NIH HHS P50 MH119029
6 · The paper itself

Abstract

Importance: Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective: To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depression using patient-level information. Data Sources: We searched PubMed, Embase, PsycInfo, and Cochrane Library to identify randomized clinical trials (RCTs) published up to January 1, 2019. Study Selection: Eligible RCTs were those comparing guided or unguided iCBT against each other or against any control intervention in individuals with depression. Available individual patient data (IPD) was collected from all eligible studies. Depression symptom severity was assessed after treatment, 6 months, and 12 months after randomization. Data Extraction and Synthesis: We conducted a systematic review and IPD network meta-analysis and estimated relative treatment effect sizes across different patient characteristics through IPD network meta-regression. Main Outcomes and Measures: Patient Health Questionnaire-9 (PHQ-9) scores. Results: Of 42 eligible RCTs, 39 studies comprising 9751 participants with depression contributed IPD to the IPD network meta-analysis, of which 8107 IPD were synthesized. Overall, both guided and unguided iCBT were associated with more effectiveness as measured by PHQ-9 scores than control treatments over the short term and the long term. Guided iCBT was associated with more effectiveness than unguided iCBT (mean difference [MD] in posttreatment PHQ-9 scores, -0.8; 95% CI, -1.4 to -0.2), but we found no evidence of a difference at 6 or 12 months following randomization. Baseline depression was found to be the most important modifier of the relative association for efficacy of guided vs unguided iCBT. Differences between unguided and guided iCBT in people with baseline symptoms of subthreshold depression (PHQ-9 scores 5-9) were small, while guided iCBT was associated with overall better outcomes in patients with baseline PHQ-9 greater than 9. Conclusions and Relevance: In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression, benefits were more substantial in individuals with moderate to severe depression. Unguided iCBT was associated with similar effectiveness among individuals with symptoms of mild/subthreshold depression. Personalized treatment selection is entirely possible and necessary to ensure the best allocation of treatment resources for depression.

Indexed as

Cognitive Behavioral TherapyInternet-Based InterventionDepressionDepressive DisorderHumans

Identifiers

PMID33471111
PMCPMC8027916

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 2 more above

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.