Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Sep 12, 2021
Date Accepted: Feb 7, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Internet-Delivered Interventions for Depression and Anxiety Symptoms in Children and Young People: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Mental health difficulties in children and adolescents are highly prevalent and expected to increase due to the consequences of COVID-19 mitigation measures. Internet-delivered interventions offer a promising opportunity for increasing access to mental health treatments. Research has demonstrated their effectiveness as a treatment for adult depression and anxiety. The current work provides an up-to-date examination of available intervention options and their effectiveness for children and young people.
Objective:
This systematic review and meta-analysis aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in children and young people (CYP).
Methods:
Systematic literature searches were conducted throughout November 2020 using PubMed, PsychINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in young people aged under 18 provided either to the children or parents. Studies were eligible for the meta-analysis if they conducted a randomized controlled trial. Risk of bias via the CLEAR nonpharmacological treatments (NPT) checklist and publication bias were evaluated. We conducted a meta-analysis of study effects using random-effect models, calculating Hedge’s g at post-treatment.
Results:
Twenty-three studies met eligibility criteria for the systematic review and 16 of these were included in the meta-analysis, across which there were 21 comparisons. Random-effect models detected a significant small effect for anxiety symptoms (g=-0.25; 95% CI -0.38, -0.12; P=.0002) and a small but not significant effect for depression (g=-0.27; 95% CI -0.55, 0.01; P=.058) in favor of internet-delivered interventions compared to control groups. Regarding secondary outcomes, impaired functioning showed a small effect of treatment across 8 comparisons (g=0.52; 95% CI 0.24, 0.80; P=.0003) and 5 comparisons of quality of life detected no effect (g=-0.01; 95% CI -0.22, 0.21; P=.94).
Conclusions:
Results hint at the potential of internet-delivered interventions for young people with symptoms of anxiety or depression that to date has not been tapped into. The review highlights an opportunity for the development of population specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP. Clinical Trial: Systematic review registration PROSPERO: CRD42020220171
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