Evidence map›Paper›PMID 37358893›Full record

SynthesisJournal of medical Internet research2023

The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data.

Lasse B Sander, Marie Beisemann, Philipp Doebler, Hannah Moon Micklitz, Ad Kerkhof, Pim Cuijpers, Philip Batterham, Alison Calear, Helen Christensen, Eva De Jaegere and 13 more

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

Synthesis in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
7.8field-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

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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  8. Innovations to improve outcomes and uptake of psychotherapies for mental disorders: a state-of-the-art review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
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  10. DNA hypomethylation of theFrontiers in neurology · 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

23 authors at 10 institutions in 6 countries.

Lasse B SanderMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0000-0002-4222-9837
Marie BeisemannDepartment of Statistics, Technical University of Dortmund, Dortmund, Germany.ORCID 0000-0001-6977-167X
Philipp DoeblerDepartment of Statistics, Technical University of Dortmund, Dortmund, Germany.ORCID 0000-0002-2946-8526
Hannah Moon 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.ORCID 0000-0003-1701-5332
Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.ORCID 0000-0001-5497-2743
Philip BatterhamCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia.ORCID 0000-0002-4547-6876
Alison CalearCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia.ORCID 0000-0002-7028-725X
Helen ChristensenBlack Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0003-0435-2065
Eva De JaegereDepartment of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium.ORCID 0000-0001-6111-5352
Matthias DomhardtDepartment of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.ORCID 0000-0002-3243-8926
Annette ErlangsenDanish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.ORCID 0000-0003-3475-0558
Ozlem Eylem-van BergeijkFaculty of Behavioral and Social Sciences, Webster University Leiden, Leiden, Netherlands.ORCID 0000-0002-5695-9523
Ryan HillDepartment of Psychology, Louisiana State University, Baton Rouge, LA, United States.ORCID 0000-0002-6342-2839
Charlotte MühlmannDanish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark.ORCID 0000-0001-9793-1626
Marie ÖsterleMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0009-0001-0339-3394
Jeremy PettitDepartment of Psychology, Center for Children and Families, Florida International University, Miami, FL, United States.ORCID 0000-0002-7426-9411
Gwendolyn PortzkyDepartment of Head and Skin, Flemish Centre of Expertise in Suicide Prevention, Ghent University, Ghent, Belgium.ORCID 0000-0003-1435-286X
Lena SteublDepartment of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany.ORCID 0000-0002-8508-5271
Bregje van SpijkerCentre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia.ORCID 0000-0002-8124-2559
Joseph TigheBlack Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0003-3553-6721
Aliza Werner-SeidlerBlack Dog Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-9046-6159
Rebekka BüscherMedical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0000-0001-8931-0942
University of Freiburg · DEAustralian National University · AUBlack Dog Institute · AUDanish National Centre for Social Research · DKGhent University · BETU Dortmund University · DEUniversität Ulm · DEVrije Universiteit Amsterdam · NLFlorida Department of Children and Families · USLouisiana State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuicide is a global public health problem. Digital interventions are considered a low-threshold treatment option for people with suicidal ideation or behaviors. Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. However, suicidal ideation often is related to additional mental health problems, which should be addressed for optimal care. Yet, the effects of iCBT on related symptoms, such as depression, anxiety, and hopelessness, remain unclear.

objectiveWe aimed to analyze whether digital interventions targeting suicidal ideation had an effect on related mental health symptoms (depression, anxiety, and hopelessness).

methodsWe systematically searched CENTRAL, PsycInfo, Embase, and PubMed for randomized controlled trials that investigated guided or unguided iCBT for suicidal ideation or behaviors. Participants reporting baseline suicidal ideation were eligible. Individual participant data (IPD) were collected from eligible trials. We conducted a 1-stage IPD meta-analysis on the effects on depression, anxiety, and hopelessness-analyzed as 2 indices: symptom severity and treatment response.

resultsWe included IPD from 8 out of 9 eligible trials comprising 1980 participants with suicidal ideation. iCBT was associated with significant reductions in depression severity (b=-0.17; 95% CI -0.25 to -0.09; P<.001) and higher treatment response (ie, 50% reduction of depressive symptoms; b=0.36; 95% CI 0.12-0.60; P=.008) after treatment. We did not find significant effects on anxiety and hopelessness.

conclusionsiCBT for people with suicidal ideation revealed significant effects on depression outcomes but only minor or no effects on anxiety and hopelessness. Therefore, individuals with comorbid symptoms of anxiety or hopelessness may require additional treatment components to optimize care. Studies that monitor symptoms with higher temporal resolution and consider a broader spectrum of factors influencing suicidal ideation are needed to understand the complex interaction of suicidality and related mental health symptoms.

Indexed as

Cognitive Behavioral TherapyDepressionAnxietyHumansInternetSuicidal IdeationanxietyCBTcognitive behavioral therapydepressiondepressivehopelessnessinternet-based cognitive behavioral therapymental healthmeta-analysispsychotherapyreview methodsuicidalsuicidal ideationsuicidesystematic review

Identifiers

PMID37358893
PMCPMC10337381
OpenAlexW4382011882

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.