Evidence map›Paper›PMID 36535686›Full record

SynthesisEvidence-based mental health2022

Digital cognitive-behavioural therapy to reduce suicidal ideation and behaviours: a systematic review and meta-analysis of individual participant data.

Rebekka Büscher, Marie Beisemann, Philipp Doebler, Hannah M Micklitz, Ad Kerkhof, Pim Cuijpers, Philip J Batterham, Alison L Calear, Helen Christensen, Eva De Jaegere and 14 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Evidence-based mental health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
6.7field-weighted citation impact, top 2% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 46 citations in OpenAlex.

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  12. Reducing the 'Silence Between Sessions': A Qualitative Study on Youth and Professionals' Perspectives on Digital Tools for Suicide Prevention.Health expectations : an international journal of public participation in health care and health policy · 2026
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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

24 authors at 14 institutions in 7 countries.

Rebekka BüscherMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany rebekka.buescher@mps.uni-freiburg.de.ORCID 0000-0001-8931-0942
Marie BeisemannDepartment of Statistics, TU Dortmund University, Dortmund, Germany.ORCID 0000-0001-6977-167X
Philipp DoeblerDepartment of Statistics, TU Dortmund University, Dortmund, Germany.
Hannah M MicklitzMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0000-0002-4377-7704
Ad KerkhofDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.ORCID 0000-0001-5497-2743
Philip J BatterhamCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.ORCID 0000-0002-4547-6876
Alison L CalearCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.ORCID 0000-0002-7028-725X
Helen ChristensenBlack Dog Institute, UNSW Sydney, Randwick, New South Wales, Australia.
Eva De JaegereDepartment of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Gent, Belgium.
Matthias DomhardtDepartment of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.
Annette ErlangsenCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
Ozlem Eylem van BergeijkWebster University, Leiden Campus, Leiden, The Netherlands.ORCID 0000-0002-5695-9523
Ryan HillDepartment of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA.
Anita LunguLyra Health Inc, Burlingame, California, USA.
Charlotte MühlmannDanish Research Institute for Suicide Prevention, Copenhagen Research Centre for Mental Health, Copenhagen, Denmark.ORCID 0000-0001-9793-1626
Jeremy W PettitDepartment of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA.ORCID 0000-0002-7426-9411
Gwendolyn PortzkyDepartment of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Gent, Belgium.
Lena S SteublDepartment of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.ORCID 0000-0002-8508-5271
Bregje A J van SpijkerCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
Joseph TigheBlack Dog Institute, UNSW Sydney, Randwick, New South Wales, Australia.
Aliza Werner-SeidlerBlack Dog Institute, UNSW Sydney, Randwick, New South Wales, Australia.
Chelsey R WilksDepartment of Psychological Sciences, University of Missouri-St Louis, St Louis, Missouri, USA.
Lasse B SanderMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Australian National University · AUBlack Dog Institute · AUUniversity of Freiburg · DEFlemish Community · BETU Dortmund University · DEUniversität Ulm · DEBabeș-Bolyai University · RODanish National Centre for Social Research · DKFlorida Department of Children and Families · USLeiden University · NLLouisiana State University · USUniversity of Missouri–St. Louis · USVrije Universiteit Amsterdam · NLWolters Kluwer Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

questionDigital interventions based on cognitive-behavioural therapy (iCBT) is associated with reductions in suicidal ideation. However, fine-grained analyses of effects and potential effect-moderating variables are missing. This study aimed to investigate the effectiveness of iCBT on suicidal ideation, effect moderators, effects on suicide attempts and predictors of adherence. STUDY SELECTION AND ANALYSIS: We systematically searched CENTRAL, PsycINFO, Embase and PubMed for randomised controlled trials that investigated iCBT for suicidal ideation or behaviours. Participants reporting baseline suicidal ideation were eligible. We conducted a one-stage individual participant data (IPD) meta-analysis. Suicidal ideation was the primary outcome, analysed as three indices: severity of suicidal ideation, reliable changes and treatment response.

findingsWe included IPD from nine out of ten eligible trials (2037 participants). iCBT showed significant reductions of suicidal ideation compared with control conditions across all indices (severity: b=-0.247, 95% CI -0.322 to -0.173; reliable changes: b=0.633, 95% CI 0.408 to 0.859; treatment response: b=0.606, 95% CI 0.410 to 0.801). In iCBT, the rate of reliable improvement was 40.5% (controls: 27.3%); the deterioration rate was 2.8% (controls: 5.1%). No participant-level moderator effects were identified. The effects on treatment response were higher for trials with waitlist-controls compared with active controls. There were insufficient data on suicide attempts. Human support and female gender predicted treatment adherence. The main source of potential bias was missing outcome data.

conclusionsThe current evidence indicates that iCBT is effective in reducing suicidal ideation irrespective of age, gender and previous suicide attempts. Future studies should rigorously assess suicidal behaviour and drop-out reasons.

Indexed as

Cognitive Behavioral TherapySuicidal IdeationFemaleHumansSuicide, Attemptedadult psychiatrychild & adolescent psychiatrysuicide & self-harm

Identifiers

PMID36535686
PMCPMC9811070
OpenAlexW4312066944

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.