Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 22, 2021
Date Accepted: Dec 3, 2021
Computerised Cognitive Behavioural Therapy (cCBT) for the treatment of depression and anxiety in adolescents: A systematic review and meta-analysis
ABSTRACT
Background:
Depression and anxiety presents a significant public health concern in the adolescent age group. Computerised Cognitive Behaviour Therapy (cCBT) has emerged as a potential means for intervention, but its efficacy in the adolescent age group remains unestablished.
Objective:
This review aimed to systematically review and meta-analyse findings on the efficacy of cCBT for the treatment of adolescent depression and anxiety.
Methods:
Embase, PsychInfo, and Ovid Medline were systematically searched for randomised controlled trials (RCTs) in the English language which investigated the efficacy of cCBT for reducing self-reported depression and/or anxiety in adolescents aged 11 to 19 years. Titles, abstracts and full texts were screened for eligibility by two independent researchers. A random-effects meta-analysis was conducted to pool the effects of cCBT on depression and anxiety symptom scores compared to control groups.
Results:
A total of 16 RCTs were eligible for inclusion in this review, of which 13 were included in the meta-analysis. Small but statistically significant effects of cCBT were detected, with cCBT conditions showing lower symptom scores at follow-up compared to control conditions for both anxiety (SMD=-0.21, 95% CI=-0.33 to -0.09, I2=36.2%) and depression (SMD=-0.23, 95% CI=-0.39 to -0.07, I2=59.5%). Secondary analyses suggested that cCBT may be comparable to alterative, active interventions (such as face to face therapy or treatment as usual).
Conclusions:
This meta-analysis reinforces the efficacy of cCBT for the treatment of anxiety and depression, and is the first to examine this exclusively in the adolescent age group. Future research could work to identify the active components of these interventions, towards optimising their development and increasing the feasibility and acceptability of cCBT in this age group.
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